GLEN C JACOB M.D. NPI 1295990976

NPI Information

  • NPI: 1295990976
  • Provider Name: GLEN C JACOB, M.D.
  • Classification: Surgery - 2086S0105X
  • Specialization: Surgery of the Hand
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 1175 EAST MOUNTAIN BLVD.
    WILKES-BARRE, PA
    ZIP 18702
  • Phone: (570) 808-1093

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NPI Details

Glen C Jacob, M.D. is a surgery of the hand surgery in Wilkes-barre, PA with 24 years of experience. The provider is a surgeon with expertise in the investigation, preservation and restoration by medical, surgical and rehabilitative means, of all structures of the upper extremity directly affecting the form and function of the hand and wrist. Glen C Jacob, M.D. NPI is 1295990976. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

1175 EAST MOUNTAIN BLVD.
WILKES-BARRE, PA
ZIP 18702-885
Phone: (570) 808-1093
Fax: (570) 808-7878

The NPI 1295990976 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

  • Established patient office or other outpatient visit, 20-29 minutes (HCPCS:99213)
  • New patient office or other outpatient visit, 30-44 minutes (HCPCS:99203)
  • Established patient office or other outpatient visit, 10-19 minutes (HCPCS:99212)
  • Injection into tendon or ligament (HCPCS:20550)
  • Injection, betamethasone acetate 3 mg and betamethasone sodium phosphate 3 mg (HCPCS:J0702)
  • Incision of tendon covering of finger (HCPCS:26055)
  • Release and/or relocation of hand nerve (HCPCS:64721)
  • Release and/or relocation of hand nerve (HCPCS:64721)
  • New patient office or other outpatient visit, 15-29 minutes (HCPCS:99202)
  • Mastectomy (HCPCS:NAN04)

The enumeration date for this NPI number is 7/22/2008 and was last updated on 8/11/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1208600000XSurgeryMD452555PENNSYLVANIANo
2208600000XSurgeryN0127TEXASNo
32086S0105XSurgerySurgery of the HandMD452555VPENNSYLVANIAYes
42086S0105XSurgerySurgery of the Hand24108WEST VIRGINIANo
52086S0105XSurgerySurgery of the Hand25MA08617700NEW JERSEYNo

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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