Individual provider Active NPI

Eugene M. Glavin, MD

  • Diagnostic Radiology Physician
  • Lebanon, PA
National Provider Identifier
1154315711
Registry record updated Aug 3, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
MD072803L Issued in PA
Practice address
252 S. 4TH Street
Good Samaritan Hospital
Lebanon, PA 17042
Phone
(717) 270-7644
Fax
(302) 358-2066
NPI assigned
Sep 9, 2005
Last updated
Aug 3, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 3, 2011

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X C10005739 DE
Pediatrics Physician 208000000X C10005739 DE
Diagnostic Radiology Physician 2085R0202X MD072803L PA Primary

Addresses

Primary practice location

252 S. 4TH Street
Good Samaritan Hospital
Lebanon, PA 17042

Mailing address

540 Royal Rd
Lebanon, PA 17042-8929
Phone (302) 547-3399

Other identifiers 1

IdentifierTypeStateIssuer
1000024323MedicaidDE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, NJ2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20110513000303 PA Practitioner - Diagnostic Radiology 1759468689 Reassigns benefits to 4 organizations
I20160712002593 NJ Practitioner - Diagnostic Radiology 1759468689 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Clinical Health Care Associates of New Jersey PCGroup PAC ID 0749180198, shared by 7 NPIs, 793 clinicians
University of Penn-Medical GroupGroup PAC ID 6204730955, 3,433 clinicians

Practice addresses (Care Compare)

1006 Mantua Pike
Woodbury, NJ 08097-1221
Phone (856) 686-8282

1865 Route 70 E 130
Rad Cherry Hill
Cherry Hill, NJ 08003-2013
Phone (856) 433-2535

3400 Spruce St
Philadelphia, PA 19104-4238
Phone (215) 662-3000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
C10005739DEMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Clinical Health Care Associates of New Jersey, PC Internal Medicine CurrentSince May 20, 2016 Accepting new patients
University of Penn-Medical Group Current Accepting new patients
Clinical Health Care Associates of New Jersey, P.C. Internal Medicine CurrentSince May 20, 2016 Accepting new patients
Clinical Health Care Associates of New Jersey, PC Current Accepting new patients
University of Penn-Medical Group Diagnostic Radiology CurrentSince Oct 1, 2015 Accepting new patients
Pottstown Clinic Company LLC Internal Medicine CurrentSince Oct 1, 2011 Accepting new patients
University of Penn-Medical Group CurrentSince Oct 1, 2015 Accepting new patients
Progressive Physician Assoc Inc Diagnostic Radiology CurrentSince Jul 14, 2025 Accepting new patients
Grandview Radiology Associates Diagnostic Radiology CurrentSince Apr 10, 2023 Accepting new patients
Clinical Health Care Associates of New Jersey, PC CurrentSince Sep 1, 2016 Accepting new patients
University of Penn - Medical Group Past Accepting new patients
MRI Group, LLP Diagnostic Radiology Past Accepting new patients
MRI Group, LLP Diagnostic Radiology Past Accepting new patients

Locations

1865 Route 70 E
Ste 130
Cherry Hill, NJ 08003
Phone (856) 433-2535

3205 Fire Rd
Egg Hbr Twp, NJ 08234
Phone (609) 407-1113

1006 Mantua Pike
Woodbury Hts, NJ 08097
Phone (856) 845-6880

3 Parkinsons Rd
East Stroudsburg, PA 18301
Phone (570) 424-1102

801 Ostrum St
Fountain Hill, PA 18015
Phone (610) 954-2200

3624 Market St
Fl 2
Philadelphia, PA 19104
Phone (215) 615-3669

1600 E High St
Pottstown, PA 19464
Phone (610) 327-7485

730 S Hanover St
Pottstown, PA 19465
Phone (610) 323-6835

700 Lawn Ave
Sellersville, PA 18960
Phone (215) 453-4000

711 Lawn Ave
Ste 2
Sellersville, PA 18960
Phone (215) 257-1050

100 St Lukes Ln
Stroudsburg, PA 18360
Phone (272) 212-1000

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 2

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

NPI Registry JSON

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

{
    "created_epoch": "1126224000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1312329600000",
    "number": "1154315711",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "540 ROYAL RD",
            "city": "LEBANON",
            "state": "PA",
            "postal_code": "170428929",
            "telephone_number": "302-547-3399",
            "fax_number": "302-358-2066"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "252 S. 4TH STREET",
            "address_2": "GOOD SAMARITAN HOSPITAL",
            "city": "LEBANON",
            "state": "PA",
            "postal_code": "17042",
            "telephone_number": "717-270-7644",
            "fax_number": "302-358-2066"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLAVIN",
        "first_name": "EUGENE",
        "middle_name": "M.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-09",
        "last_updated": "2011-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "DE",
            "license": "C10005739",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "DE",
            "license": "C10005739",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "PA",
            "license": "MD072803L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1000024323",
            "state": "DE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lebanon, PA

Sources for this page

Verify at the official NPI Registry.