Individual provider Active NPI

Anthony J Liotta, PA-C

  • Surgical Physician Assistant
  • Allentown, PA
National Provider Identifier
1003158973
Registry record updated Feb 17, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
OA004026 Issued in PA
Practice address
1240 S Cedar Crest Blvd
Suite 308
Allentown, PA 18103-6369
Phone
(610) 402-1314
NPI assigned
Mar 19, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 17, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X OA004026 PA Primary

Addresses

Primary practice location

1240 S Cedar Crest Blvd
Suite 308
Allentown, PA 18103-6369

Mailing address

4104 Barnstaple CT
Bensalem, PA 19020-4831

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170213000857 PA Practitioner - Physician Assistant 1850514605 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lehigh Valley Physician GroupGroup PAC ID 3072425123, 2,512 clinicians

Practice addresses (Care Compare)

1200 S Cedar Crest Blvd
Allentown, PA 18103-6202

1200 S Cedar Crest Blvd 3Rd FL Kasych
LVPG Burn Surgery
Allentown, PA 18103-6202
Phone (610) 402-8355

1200 S Cedar Crest Blvd FL
1 LVPG Nephrology
Allentown, PA 18103-6202
Phone (610) 402-8510

1210 S Cedar Crest Blvd
Allentown, PA 18103-6235
Phone (610) 402-3888

1240 S Cedar Crest Blvd
305 LVPG Hematology Oncology
Allentown, PA 18103-6370
Phone (610) 402-9050

200 E Brown St
LVPG Family Medicine Esu
East Stroudsburg, PA 18301-3006
Phone (272) 762-4378

2100 Mack Blvd
FL 4
Allentown, PA 18103-5622

Hospital & facility affiliations

  • Lehigh Valley Hospital Hospital, Allentown, PA, CCN 390133

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
OA004026PAMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Lehigh Valley Physician Group CurrentSince Jan 1, 2017 Accepting new patients
Schuylkill Health System Medical Group, Inc. CurrentSince Jul 1, 2021 Accepting new patients
Family Care Centers Inc. CurrentSince Dec 21, 2022 Accepting new patients
Lehigh Valley Physician Group CurrentSince Jan 1, 2017 Accepting new patients

Locations

1210 S Cedar Crest Blvd
Ste 3300
Allentown, PA 18103
Phone (610) 402-8506

1240 S Cedar Crest Blvd
Ste 308
Allentown, PA 18103
Phone (610) 402-1175

2100 Mack Blvd
Fl 2
Allentown, PA 18103

500 Plaza Ct
East Stroudsburg, PA 18301
Phone (570) 426-2330

5649 Wynnewood Dr
Ste 104
Laurys Station, PA 18059
Phone (610) 262-6641

700 Schuylkill Manor Rd
Ste 3
Pottsville, PA 17901
Phone (570) 621-4440

Interoperability endpoints

  • Direct secure messaging: aliotta164204@direct2.lvhn.org

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1363651200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1487289600000",
    "number": "1003158973",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4104 BARNSTAPLE CT",
            "city": "BENSALEM",
            "state": "PA",
            "postal_code": "190204831"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1240 S CEDAR CREST BLVD",
            "address_2": "SUITE 308",
            "city": "ALLENTOWN",
            "state": "PA",
            "postal_code": "181036369",
            "telephone_number": "610-402-1314"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIOTTA",
        "first_name": "ANTHONY",
        "middle_name": "J",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-03-19",
        "last_updated": "2017-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "PA",
            "license": "OA004026",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Allentown, PA

Sources for this page

Verify at the official NPI Registry.