NPIMap

Individual provider Active NPI

Bram Sakdiponephong, MS, DO

  • Family Medicine Physician
  • Nazareth, PA
National Provider Identifier
1003307778
Registry record updated Jul 24, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
OS021532 Issued in PA
Practice address
6059 Jandy Blvd
103
Nazareth, PA 18064
Phone
(484) 526-3555
Fax
(833) 822-5230
NPI assigned
May 29, 2018
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 24, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X OS021532 PA Primary

Addresses

Primary practice location

6059 Jandy Blvd
103
Nazareth, PA 18064

Mailing address

4059 Jandy Blvd # 103
Nazareth, PA 18064-8819
Phone (484) 503-6450

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211213000623 PA Practitioner - Family Practice 7618225541 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Philadelphia College of Osteopathic Medicine, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
St Lukes Physician Group IncGroup PAC ID 6709798333, 2,161 clinicians

Practice addresses (Care Compare)

1208 Hanover Ave
Allentown, PA 18109-2017
Phone (610) 437-6490

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
97.13 of 100Reported as apm
Quality
82.27
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Removal or shaving of skin growth1-10
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy, Master of Science

State licenses

LicenseStateTypeSpecialty
OT018235PAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St Luke'S Physician Group Inc Family Medicine CurrentSince Dec 6, 2021 Accepting new patients
St. Luke'S Physician Group, Inc. Family Medicine Current Accepting new patients
St. Luke'S Physician Group Inc Family Medicine CurrentSince Dec 6, 2021 Accepting new patients
St. Luke'S Physician Group, Inc Past Accepting new patients

Locations

1208 Hanover Ave
Allentown, PA 18109
Phone (610) 437-6490

2830 Easton Ave
Bethlehem, PA 18017
Phone (484) 526-3555

4311 Easton Ave
Bethlehem, PA 18020
Phone (610) 954-3600

801 Ostrum St
Fountain Hill, PA 18015
Phone (610) 954-2200

Interoperability endpoints

  • Direct secure messaging: bram.sakdiponephong@slpg.direct-sluhn.org

Organizations & group practices 4

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 13

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

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1527552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784851200000",
    "number": "1003307778",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4059 JANDY BLVD # 103",
            "city": "NAZARETH",
            "state": "PA",
            "postal_code": "180648819",
            "telephone_number": "484-503-6450",
            "fax_number": "833-820-1004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6059 JANDY BLVD",
            "address_2": "103",
            "city": "NAZARETH",
            "state": "PA",
            "postal_code": "18064",
            "telephone_number": "484-526-3555",
            "fax_number": "833-822-5230"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAKDIPONEPHONG",
        "first_name": "BRAM",
        "credential": "MS, DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-05-29",
        "last_updated": "2026-07-24",
        "certification_date": "2026-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "OS021532",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Nazareth, PA

Sources for this page

Verify at the official NPI Registry.