Individual provider Active NPI

Stephen J Gluckman, MD

  • Infectious Disease Physician
  • Philadelphia, PA
National Provider Identifier
1932136850
Registry record updated May 31, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Infectious Disease PhysicianTaxonomy code 207RI0200X
License
MD013642E Issued in PA
Practice address
51 N 39TH St
Mab, Suite 102
Philadelphia, PA 19104-2640
Phone
(215) 662-9990
Fax
(215) 243-3297
NPI assigned
Jun 27, 2006
Last updated
May 31, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 31, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD013642E PA
Infectious Disease Physician 207RI0200X MD013642E PA Primary

Addresses

Primary practice location

51 N 39TH St
Mab, Suite 102
Philadelphia, PA 19104-2640

Mailing address

51 N. 39TH Street
Mab, Suite 102
Philadelphia, PA 19104-2640
Phone (215) 662-9990

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
I20110204000231 PA Practitioner - HospitalistPractitioner - Internal MedicinePractitioner - Infectious Disease 8022298298 Reassigns benefits to 3 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
University of Penn - Medical Group Internal Medicine Current Accepting new patients
University of Penn-Medical Group Infectious Disease CurrentSince Sep 1, 1993 Accepting new patients
University of Penn-Medical Group Internal Medicine CurrentSince Jan 1, 1966 Accepting new patients
University of Penn - Medical Group Internal Medicine CurrentSince Nov 6, 2010 Accepting new patients
University of Penn-Medical Group CurrentSince Jan 1, 1966 Accepting new patients

Locations

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

250 King of Prussia Rd
Radnor, PA 19087
Phone (610) 902-1800

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, 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": "1151366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1464652800000",
    "number": "1932136850",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "51 N. 39TH STREET",
            "address_2": "MAB, SUITE 102",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191042640",
            "telephone_number": "215-662-9990",
            "fax_number": "215-243-3297"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "51 N 39TH ST",
            "address_2": "MAB, SUITE 102",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191042640",
            "telephone_number": "215-662-9990",
            "fax_number": "215-243-3297"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLUCKMAN",
        "first_name": "STEPHEN",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-27",
        "last_updated": "2016-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MD013642E",
            "primary": false
        },
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "PA",
            "license": "MD013642E",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.