Active NPI
Jaclyn Gleske, PA-C
- Physician Assistant
- Suwanee, GA
National Provider Identifier
1073961850
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 13729
- Practice address
- 1300 Peachtree Industrial Blvd Ste 4101
Suwanee, GA 30024-4542 - Phone
- (770) 831-5525
- NPI assigned
- Jun 2, 2016
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 13729 | GA | Primary |
| Physician Assistant | 363A00000X | MA063911 | PA | |
| Physician Assistant | 363A00000X | OH |
Addresses
Primary practice location
1300 Peachtree Industrial Blvd Ste 4101
Suwanee, GA 30024-4542
Mailing address
1300 Peachtree Industrial Blvd Ste 4101
Suwanee, GA 30024-4542
Phone (770) 831-5525
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in PA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Geisinger Clinic | Current | Accepting new patients | |
| Geisinger-HM Joint Venture, LLC | Physician Assistant | Current | Accepting new patients |
| Geisinger-HM Joint Venture, LLC | Current | Accepting new patients |
Locations
224 N Logan Blvd
Burnham, PA 17009
Phone (717) 242-0196
100 N Academy Ave
Danville, PA 17822
10 Choate Cir
Montoursville, PA 17754
Phone (570) 368-5566
Organizations & group practices 5
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Family Medicine Physician
- Danville, PA
- NPI 1366493868
-
- Family Medicine Physician
- Lock Haven, PA
- NPI 1144876137
-
- Diagnostic Radiology Physician
- Danville, PA
- NPI 1558313023
-
- Family Medicine Physician
- Williamsport, PA
- NPI 1073075909
Physician Assistant
-
- Gastroenterology Physician
- Montoursville, PA
- NPI 1396207015
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1464825600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1778457600000",
"number": "1073961850",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1300 PEACHTREE INDUSTRIAL BLVD STE 4101",
"city": "SUWANEE",
"state": "GA",
"postal_code": "300244542",
"telephone_number": "770-831-5525"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1300 PEACHTREE INDUSTRIAL BLVD STE 4101",
"city": "SUWANEE",
"state": "GA",
"postal_code": "300244542",
"telephone_number": "770-831-5525"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GLESKE",
"first_name": "JACLYN",
"name_prefix": "Ms.",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-06-02",
"last_updated": "2026-05-11",
"certification_date": "2026-05-11",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "GA",
"license": "13729",
"primary": true
},
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "PA",
"license": "MA063911",
"primary": false
},
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "OH",
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Suwanee, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.