Individual provider Active NPI

John E Connelly, DO

  • Family Medicine Physician
  • Allentown, PA
National Provider Identifier
1013982867
Registry record updated Dec 22, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
OS007130L Issued in PA
Practice address
501 N 17TH St
Suite # 108
Allentown, PA 18104-5044
Phone
(610) 434-4760
Fax
(610) 820-9122
NPI assigned
Feb 22, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 22, 2011

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 OS007130L PA Primary

Addresses

Primary practice location

501 N 17TH St
Suite # 108
Allentown, PA 18104-5044

Mailing address

501 N 17TH St
Suite #108
Allentown, PA 18104-5044
Phone (610) 954-6048

Other identifiers 1

IdentifierTypeStateIssuer
0012679810004MedicaidPA

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050425000980 PA Practitioner - Family Practice 6608815105 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

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

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
St. Luke'S Physician Group, Inc. Family Medicine Current Accepting new patients
St. Luke'S Physician Group, Inc. Family Medicine Current Accepting new patients
St. Luke'S Physician Group, Inc. Family Medicine CurrentSince Feb 6, 1992 Accepting new patients
St Luke'S Physician Group Inc Family Medicine CurrentSince Feb 6, 1992 Accepting new patients

Locations

3050 Hamilton Blvd
Allentown, PA 18103
Phone (484) 223-3300

3050 Hamilton Blvd
Ste 100
Allentown, PA 18103
Phone (484) 526-6048

501 N 17th St
Ste 108
Allentown, PA 18104
Phone (610) 434-4760

2200 Hamilton St
Ste 200
Allentown, PA 18104
Phone (610) 434-4760

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

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.

NPI Registry JSON

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

{
    "created_epoch": "1140566400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1324512000000",
    "number": "1013982867",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 N 17TH ST",
            "address_2": "SUITE #108",
            "city": "ALLENTOWN",
            "state": "PA",
            "postal_code": "181045044",
            "telephone_number": "610-954-6048",
            "fax_number": "610-954-3189"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 N 17TH ST",
            "address_2": "SUITE # 108",
            "city": "ALLENTOWN",
            "state": "PA",
            "postal_code": "181045044",
            "telephone_number": "610-434-4760",
            "fax_number": "610-820-9122"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONNELLY",
        "first_name": "JOHN",
        "middle_name": "E",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-22",
        "last_updated": "2011-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "OS007130L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0012679810004",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Allentown, PA

Sources for this page

Verify at the official NPI Registry.