Jordan Glicksman, MD
Otolaryngology in Danvers, MA. Individual provider (NPI-1).
NPI number1124479282
StatusActive
Last updated in NPPESJul 21, 2022
Details
- NPI
- 1124479282
- Entity type
- Individual (NPI-1)
- Name
- Jordan Glicksman
- Credential
- MD
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Jun 29, 2016
- Last updated
- Jul 21, 2022
Medicare and OIG
- Medicare enrolled (PECOS)
- Yes · PRACTITIONER - OTOLARYNGOLOGY
- Can order and refer
- Part B Yes · DME Yes · Home health Yes · Power mobility Yes · Hospice Yes
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207Y00000X | Otolaryngology | 270202 | MA | Yes |
Practice location
104 Endicott St Ste 100Danvers, MA 01923-3623
Phone 978-745-6601
Mailing address
104 Endicott St Ste 100Danvers, MA 01923-3623
Phone 978-745-6601
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This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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