NPIMap

Individual provider Active NPI

Samantha Jimenez

  • Medical Physician Assistant
  • Bethlehem, PA
National Provider Identifier
1003665654
Registry record updated Sep 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
MA065738 Issued in PA
Practice address
2649 Schoenersville Rd Ste 101
Bethlehem, PA 18017-7317
Phone
(610) 402-6986
NPI assigned
May 16, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X MA065738 PA Primary

Addresses

Primary practice location

2649 Schoenersville Rd Ste 101
Bethlehem, PA 18017-7317

Mailing address

2100 Mack Blvd
4TH FL
Allentown, PA 18103
Phone (484) 884-4500

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
I20240919004279 PA Practitioner - Physician Assistant 8123569936 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
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

1250 S Cedar Crest Blvd
Allentown, PA 18103-6224

2100 Mack Blvd
FL 4
Allentown, PA 18103-5622

2545 Schoenersville Rd
Bethlehem, PA 18017-7300

2597 Schoenersville Rd
Bethlehem, PA 18017-7325
Phone (610) 402-3560

3780 Hecktown Rd
Easton, PA 18045-2355
Phone (610) 333-8888

3794 Hecktown Rd
Easton, PA 18045-2355

401 N 17TH St
203 LVPG Adolescent Medicine
Allentown, PA 18104-5052
Phone (484) 664-2450

50 Moisey Dr
Suite 101
Hazle Township, PA 18202-9297
Phone (570) 459-2226

5649 Wynnewood Dr
Laurys Station, PA 18059-1124

Hospital & facility affiliations

  • Lehigh Valley Hospital Hospital, Allentown, PA, CCN 390133
  • Lehigh Valley Hospital - Hazleton Hospital, Hazleton, PA, CCN 390185
  • Lehigh Valley Hospital - Pocono Hospital, East Stroudsburg, PA, CCN 390201
  • Schuylkill Medical Center - South Jackson Street Hospital, Pottsville, PA, CCN 390030
  • St Lukes Hospital Hospital, Bethlehem, PA, CCN 390049

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MA065738PAMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Family Care Centers Inc. CurrentSince Sep 16, 2024 Accepting new patients
Lehigh Valley Physician Group CurrentSince Sep 6, 2024 Accepting new patients
Schuylkill Health System Medical Group, Inc. CurrentSince Sep 16, 2024 Accepting new patients
Lehigh Valley Physician Group CurrentSince Sep 6, 2024 Accepting new patients
Pulmonary Associates PC Past Accepting new patients

Locations

2100 Mack Blvd
Fl 4
Allentown, PA 18103

2649 Schoenersville Rd
Ste 101
Bethlehem, PA 18017
Phone (484) 884-3600

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

320 W Pumping Station Rd
Quakertown, PA 18951
Phone (215) 529-4240

Interoperability endpoints

  • Direct secure messaging: sjimenez1126344@direct2.lvhn.org

Organizations & group practices 8

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 15

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

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1715817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726444800000",
    "number": "1003665654",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 MACK BLVD",
            "address_2": "4TH FL",
            "city": "ALLENTOWN",
            "state": "PA",
            "postal_code": "18103",
            "telephone_number": "484-884-4500",
            "fax_number": "484-884-0699"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2649 SCHOENERSVILLE RD STE 101",
            "city": "BETHLEHEM",
            "state": "PA",
            "postal_code": "180177317",
            "telephone_number": "610-402-6986"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JIMENEZ",
        "first_name": "SAMANTHA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-05-16",
        "last_updated": "2024-09-16",
        "certification_date": "2024-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "PA",
            "license": "MA065738",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bethlehem, PA

Sources for this page

Verify at the official NPI Registry.