NPIMap

Organization Active NPI

St Luke'S Physician Group Inc

  • Urology Physician
  • Bethlehem, PA
National Provider Identifier
1003326869
Registry record updated Oct 31, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
Legal business name
ST LUKE'S PHYSICIAN GROUP INC
Practice address
5325 Northgate Dr Ste 203
Bethlehem, PA 18017-9413
Phone
(610) 867-3171
Fax
(610) 867-1941
NPI assigned
Oct 6, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 31, 2017

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

Authorized official

Name
Dean W. Evans
Title
President
Phone
(484) 526-4991

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208800000X Primary

Addresses

Primary practice location

5325 Northgate Dr Ste 203
Bethlehem, PA 18017-9413

Mailing address

5325 Northgate Dr Ste 203
Bethlehem, PA 18017-9413
Phone (610) 867-3171

Other names 1

  • St. Luke's Northgate Urology Associates Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040226000062 PA Part B Supplier - Clinic/Group Practice 6709798333 Receives reassigned benefits from 3,523 practitioners
This NPI is an additional NPI on the enrollment

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 11

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1507248000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1509408000000",
    "number": "1003326869",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5325 NORTHGATE DR STE 203",
            "city": "BETHLEHEM",
            "state": "PA",
            "postal_code": "180179413",
            "telephone_number": "610-867-3171",
            "fax_number": "610-867-1941"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5325 NORTHGATE DR STE 203",
            "city": "BETHLEHEM",
            "state": "PA",
            "postal_code": "180179413",
            "telephone_number": "610-867-3171",
            "fax_number": "610-867-1941"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST LUKE'S PHYSICIAN GROUP INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-10-06",
        "last_updated": "2017-10-31",
        "status": "A",
        "authorized_official_last_name": "EVANS",
        "authorized_official_first_name": "DEAN",
        "authorized_official_middle_name": "W.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "484-526-4991"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Urology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "St. Luke's Northgate Urology Associates",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "St. Luke's Northgate Urology Associates",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bethlehem, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.