Jesse Glick, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

86 Run Valley Rd
Conestoga, PA 17516-9734

Phone

(717) 723-0147

NPI assigned

Apr 12, 2018

Sex

Male

Sole proprietor

No

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Physician Assistant

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Apr 12, 2018.

{
    "created_epoch": "1523491200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1523491200000",
    "number": "1194222398",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "86 RUN VALLEY RD",
            "city": "CONESTOGA",
            "state": "PA",
            "postal_code": "175169734",
            "telephone_number": "717-723-0147"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "86 RUN VALLEY RD",
            "city": "CONESTOGA",
            "state": "PA",
            "postal_code": "175169734",
            "telephone_number": "717-723-0147"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLICK",
        "first_name": "JESSE",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-04-12",
        "last_updated": "2018-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Allison Marie Arters
• Gabrielle Arters
• Olivia E Asso-Gonzalez
• Conestoga Ambulance Association
• Laura S Hank, LCSW
• Tiffany Johnson, LAT, ATC
• Robert Stephen Kayden Jr., R.PH.
• Dana K Leshok, CRNP
• Stacy Lois

• All providers in Conestoga, PA
• Physician Assistant in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.