NPIMap

Individual provider Active NPI

Glenn B. Mieszkalski

  • Radiation Oncology Physician
  • Harrisburg, PA
National Provider Identifier
1043325657
Registry record updated Jan 27, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiation Oncology PhysicianTaxonomy code 2085R0001X
License
MD049823L Issued in PA
Practice address
4300 Londonderry Rd Lowr Level
Harrisburg, PA 17109-5317
Phone
(717) 724-6740
Fax
(717) 724-6741
NPI assigned
Aug 21, 2006
Last updated
Jan 27, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 27, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Hematology & Oncology Physician 207RH0003X MD049823L PA
Radiation Oncology Physician 2085R0001X MD049823L PA Primary

Addresses

Primary practice location

4300 Londonderry Rd Lowr Level
Harrisburg, PA 17109-5317

Mailing address

409 S 2ND St Ste 2F
Harrisburg, PA 17104-1612
Phone (717) 231-8937

Other practice location 1

1703 Innovation Dr Ste 100
York, PA 17408-8815
Phone (717) 801-0742

Other practice location 2

2035 Technology Pkwy Ste 100
Mechanicsburg, PA 17050-9422
Phone (717) 724-6740

Other identifiers 1

IdentifierTypeStateIssuer
101107828MedicaidPA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address gmieszkalski62224@phsdirect.pinnaclehealth.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, SC2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20040921001010 PA Practitioner - Radiation Oncology 6103894779 Reassigns benefits to 5 organizations
I20260622001660 SC Practitioner - Radiation Oncology 6103894779

Care Compare profile

Medicare Care Compare
Specialty
Radiation Oncology
Education
Other, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pinnacle Health Medical ServicesGroup PAC ID 7618960493, 1,025 clinicians

Practice addresses (Care Compare)

1701 Innovation Dr
York, PA 17408-8815
Phone (717) 843-8623

1703 Innovation Dr
York, PA 17408-8815

2035 Technology Pkwy
Mechanicsburg, PA 17050-9422

2106 Harrisburg Pike
Suite 200
Lancaster, PA 17601-2644
Phone (717) 393-1771

2501 N 3Rd St
Kline Health Center Foot and Ankle
Harrisburg, PA 17110-1904
Phone (717) 782-2100

2501 N 3Rd St 2ND FL Kline HC
Reach Program
Harrisburg, PA 17110-1904
Phone (717) 782-2363

2501 N 3Rd St FL
2 Kline Health Center
Harrisburg, PA 17110-1904
Phone (717) 782-2100

2501 N 3Rd Street 2ND Floor
Pinnaclehealth Psychological Associates
Harrisburg, PA 17110-1904
Phone (717) 782-2143

300 Highland Ave
Hanover, PA 17331-2297
Phone (717) 316-3711

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Pinnacle Health Regional Physicians Hematology & Oncology CurrentSince Jul 1, 2017 Accepting new patients
Pinnacle Health Regional Physicians CurrentSince Jul 1, 2017 Accepting new patients
Pinnacle Health Medical Services CurrentSince Aug 1, 2020 Accepting new patients
Alliance Physician Services, PC CurrentSince Oct 1, 2024 Accepting new patients
Alliance Physician Services, PC CurrentSince Oct 1, 2024 Accepting new patients
Pinnacle Health Medical Services CurrentSince Aug 1, 2020 Accepting new patients
Pinnacle Health Medical Services Current Accepting new patients
Alliance Physician Services, PC Current Accepting new patients
Alliance Physician Services, PC Past Accepting new patients
Pinnacle Health Medical Services Past Accepting new patients
Pinnacle Health Medical Services Radiation Oncology Past Accepting new patients

Locations

210 Forge Rd
Boiling Springs, PA 17007
Phone (717) 249-8300

366 Alexander Spring Rd
Carlisle, PA 17015
Phone (717) 243-1900

2501 N 3rd St
Fl 2
Harrisburg, PA 17110
Phone (717) 782-2100

409 S 2nd St
Ste 2F
Harrisburg, PA 17104
Phone (717) 231-8049

211 S Gulph Rd
Ste 200
Kng of Prussa, PA 19406
Phone (610) 382-5910

2106 Harrisburg Pike
Ste 200
Lancaster, PA 17601
Phone (352) 365-6877

233 College Ave
Ste 100
Lancaster, PA 17603
Phone (717) 291-7207

233 College Ave
Ste 101
Lancaster, PA 17603
Phone (717) 735-0525

233 College Ave
Ste 203
Lancaster, PA 17603
Phone (717) 396-9167

3045 Marietta Ave
Lancaster, PA 17601
Phone (717) 299-4644

4300 Londonderry Rd
Lower Paxton, PA 17109
Phone (717) 597-7044

2035 Technology Pkwy
Ste 100
Mechanicsburg, PA 17050
Phone (717) 724-6740

656 E Swedesford Rd
Ste 120
Wayne, PA 19087
Phone (610) 273-5320

1703 Innovation Dr
Ste 100
York, PA 17408
Phone (717) 724-6740

Interoperability endpoints

  • Direct secure messaging: drglennmieszkalski@lancuro.medentdirect.com
  • Direct secure messaging: gmieszkalski19271@upmc.direct-ci.com

Organizations & group practices 13

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

View all 13

Hospital & facility affiliations 15

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 15

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1156118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611705600000",
    "number": "1043325657",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "409 S 2ND ST STE 2F",
            "city": "HARRISBURG",
            "state": "PA",
            "postal_code": "171041612",
            "telephone_number": "717-231-8937",
            "fax_number": "717-231-8588"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4300 LONDONDERRY RD LOWR LEVEL",
            "city": "HARRISBURG",
            "state": "PA",
            "postal_code": "171095317",
            "telephone_number": "717-724-6740",
            "fax_number": "717-724-6741"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1703 Innovation Dr Ste 100",
            "address_purpose": "LOCATION",
            "city": "York",
            "state": "PA",
            "postal_code": "174088815",
            "country_code": "US",
            "telephone_number": "717-801-0742",
            "fax_number": "717-801-0630",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2035 Technology Pkwy Ste 100",
            "address_purpose": "LOCATION",
            "city": "Mechanicsburg",
            "state": "PA",
            "postal_code": "170509422",
            "country_code": "US",
            "telephone_number": "717-724-6740",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MIESZKALSKI",
        "first_name": "GLENN",
        "middle_name": "B.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-21",
        "last_updated": "2021-01-27",
        "certification_date": "2021-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "PA",
            "license": "MD049823L",
            "primary": false
        },
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "PA",
            "license": "MD049823L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "101107828",
            "state": "PA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "gmieszkalski62224@phsdirect.pinnaclehealth.org",
            "affiliation": "N",
            "address_1": "4300 Londonderry Rd Lowr Level",
            "city": "Harrisburg",
            "state": "PA",
            "country_code": "US",
            "postal_code": "171095317",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Harrisburg, PA

Sources for this page

Verify at the official NPI Registry.