DR. JONATHAN SHANE GLICKSTEIN (MD) – Otolaryngology Physician, NPI 1598983371
Otolaryngology Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
273 OTOLARYNGOLOGY in MN
Provider Addresses for DR. JONATHAN SHANE GLICKSTEIN (MD)
400 E 3RD ST
DULUTH, MN 558051951
Phone: (218) 722-8364
Type: Mailing
400 E 3rd St
Duluth, MN 558051951
Phone: (218) 722-8364
Type: Location
1120 N MELVIN ST
GIBSON CITY, IL 609361477
Phone: (217) 784-2212
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 1 Open Payments records for all available years, with a total value of $15.
Total Amount is formed as General ($15) + Research ($0) + Ownership ($0) = $15.
Last reported payment date: 2024-01-03 • Largest payer in this snapshot: Acclarent, Inc ($15).
Total Amount
$15
General + Research + Ownership
Payments
1
Total payment records
General Amount
$15
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-01-03
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Acclarent, Inc | $15 |
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2021-01-04
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20210104000550 | I | Otolaryngology | IL | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 113 | 81 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 110 | 79 | $0 |
| 99204 | New patient office or other outpatient visit, 45-59 minutes | 81 | 81 | $0 |
| 92504 | Exam of ear using a microscope | 72 | 60 | $0 |
| 69210 | Removal of impacted ear wax | 66 | 49 | $0 |
Insurance plans in this area (ZIP 55805)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Physical Therapist In Private Practice | IL | |
| - | IL | |
| Diagnostic Radiology | IN | |
| - | IL | |
| Nurse Practitioner | IL | |
| Nurse Practitioner | IL | |
| - | IL | |
| Emergency Medicine | MN | |
| - | IL | |
| - | IL |
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