Individual provider Active NPI

Glenn Scott Slick Jr., MD

  • Anesthesiology Physician
  • Mechanicsburg, PA
National Provider Identifier
1588314587
Registry record updated May 10, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
MD495075 Issued in PA
Practice address
1995 Technology Pkwy
Mechanicsburg, PA 17050-8522
Phone
(717) 782-5118
Fax
(717) 782-5854
NPI assigned
Mar 24, 2022
Last updated
May 10, 2026By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 10, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207L00000X MD495075 PA Primary
Student in an Organized Health Care Education/Training Program 390200000X 1588314587 CT
Anesthesiology Physician 207L00000X 1588314587 CT

Addresses

Primary practice location

1995 Technology Pkwy
Mechanicsburg, PA 17050-8522

Mailing address

263 Farmington Ave
Farmington, CT 06030-1921
Phone (860) 679-2147

Other practice location 1

67 University Mnr E
Hershey, PA 17033-2809
Phone (570) 983-7886

Other practice location 2

263 Farmington Ave
Farmington, CT 06030-2809
Phone (860) 679-2147

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260524000013 PA Practitioner - Anesthesiology 2163992835 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Pennsylvania State University College of Medicine, 2022
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1995 Technology Pkwy
Mechanicsburg, PA 17050-8522

409 S 2ND St
Harrisburg, PA 17104-1612

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD495075PAMDAnesthesiology Physician
1588314587CTMDStudent in an Organized Health Care Education/Training Program

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1648080000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1778371200000",
    "number": "1588314587",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "263 FARMINGTON AVE",
            "city": "FARMINGTON",
            "state": "CT",
            "postal_code": "060301921",
            "telephone_number": "860-679-2147",
            "fax_number": "860-679-4624"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1995 TECHNOLOGY PKWY",
            "city": "MECHANICSBURG",
            "state": "PA",
            "postal_code": "170508522",
            "telephone_number": "717-782-5118",
            "fax_number": "717-782-5854"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "67 University Mnr E",
            "address_purpose": "LOCATION",
            "city": "Hershey",
            "state": "PA",
            "postal_code": "170332809",
            "country_code": "US",
            "telephone_number": "570-983-7886",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "263 Farmington Ave",
            "address_purpose": "LOCATION",
            "city": "Farmington",
            "state": "CT",
            "postal_code": "060302809",
            "country_code": "US",
            "telephone_number": "860-679-2147",
            "fax_number": "860-679-1275",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SLICK",
        "first_name": "GLENN",
        "middle_name": "SCOTT",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-03-24",
        "last_updated": "2026-05-10",
        "certification_date": "2026-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Anesthesiology",
            "state": "PA",
            "license": "MD495075",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "CT",
            "license": "1588314587",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "CT",
            "license": "1588314587",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mechanicsburg, PA

Sources for this page

Verify at the official NPI Registry.