St. Luke'S Physician Group, Inc.

Primary specialty

Pulmonary Disease PhysicianTaxonomy code 207RP1001X

Legal business name

ST. LUKE'S PHYSICIAN GROUP, INC.

Practice address

239 E Brown St
East Stroudsburg, PA 18301-3005

Phone

(570) 421-3872

Fax

(570) 424-6631

NPI assigned

Apr 4, 2017

Organization subpart

No

Name

Dean W Evans

Title

President

Phone

(484) 526-4991

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

• Lisa Marie Abosamra, P.A.

  • Physician Assistant
  • Bethlehem, PA
  • NPI 1982638862
  NPD
• John Brennan, MD

  • Anatomic Pathology & Clinical Pathology Physician
  • Hazleton, PA
  • NPI 1710966304
  NPD
• Daniel Patrick Dever

  • Family Medicine Physician
  • Allentown, PA
  • NPI 1497339477
  NPD
• John N. Gillard, PAC

  • Physician Assistant
  • Bethlehem, PA
  • NPI 1639274277
  NPD
• Jaclynn N Harnish, CRNP

  • Nurse Practitioner
  • Northampton, PA
  • NPI 1639617913
  NPD
• Farheen Fatima Jaffari

  • Rheumatology Physician
  • Easton, PA
  • NPI 1932549516
  NPD
• Colleen Kandt, RD

  • Registered Dietitian
  • Center Valley, PA
  • NPI 1972807766
  NPD
• Rakesh Malhotra, M.D.

  • Internal Medicine Physician
  • Allentown, PA
  • NPI 1073519666
  NPD
• Michael McLane

  • Cardiovascular Disease Physician
  • Lehighton, PA
  • NPI 1669853271
  NPD
• Gowtham Narla, MD

  • Sleep Medicine (Internal Medicine) Physician
  • Fountain Hill, PA
  • NPI 1629631155
  NPD
• Odunayo Elizabeth Ogunnaike, M.D.

  • Internal Medicine Physician
  • Paoli, PA
  • NPI 1477900421
  NPD
• Winnie J Ouma, PA-C

  • Physician Assistant
  • Bethlehem, PA
  • NPI 1760967269
  NPD

Medicare fee-for-service enrollment

Enrolled in PA

Enrollment records 1

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Mar 17, 2018.

{
    "created_epoch": "1491264000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1521244800000",
    "number": "1003349424",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "239 E. BROWN STREET",
            "city": "EAST STROUDSBURG",
            "state": "PA",
            "postal_code": "183013005",
            "telephone_number": "570-421-3872",
            "fax_number": "570-424-6631"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "239 E BROWN ST",
            "city": "EAST STROUDSBURG",
            "state": "PA",
            "postal_code": "183013005",
            "telephone_number": "570-421-3872",
            "fax_number": "570-424-6631"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "516 Jenna Dr",
            "address_purpose": "LOCATION",
            "city": "Brodheadsville",
            "state": "PA",
            "postal_code": "183227141",
            "country_code": "US",
            "telephone_number": "272-272-3200",
            "fax_number": "833-536-5294",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "239 E Brown St",
            "address_purpose": "LOCATION",
            "city": "East Stroudsburg",
            "state": "PA",
            "postal_code": "183013005",
            "country_code": "US",
            "telephone_number": "570-421-3872",
            "fax_number": "570-424-6631",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "ST. LUKE'S PHYSICIAN GROUP, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-04-04",
        "last_updated": "2018-03-17",
        "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": "207RP1001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "033001",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1007307530378",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Michael W Spence, DO
• Heather Sportelli
• St. Luke'S Hospital Monroe Campus
• St. Luke'S Physician Group
• St. Luke'S Physician Group, Inc
• St. Luke'S Physician Group, Inc.
• St. Luke'S Physician Group, Inc.
• St. Luke'S Physician Group, Inc.
• Kimberly Melissa Stambaugh, PHARM.D.
• Sonya Stamper-Woods

• All providers in East Stroudsburg, PA
• Pulmonary Disease Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.