NPIMap

Individual provider Active NPI

Michaela Bavaria, DO

  • Family Medicine Physician
  • Pottsville, PA
National Provider Identifier
1023638442
Registry record updated Jan 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
OS022975 Issued in PA
Practice address
2650 Woodglen Rd
Pottsville, PA 17901-1324
Phone
(272) 639-5755
NPI assigned
Apr 27, 2020
Last updated
Jan 22, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 22, 2025

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 OS022975 PA Primary

Addresses

Primary practice location

2650 Woodglen Rd
Pottsville, PA 17901-1324

Mailing address

2650 Woodglen Rd
Pottsville, PA 17901-1324
Phone (272) 639-5755

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
I20230822002492 PA Practitioner - Family Practice 9638509847 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Gslpg, IncGroup PAC ID 7810226875, 269 clinicians
Phoenix Rehabilitation and Health Services IncGroup PAC ID 3476464298, shared by 2 NPIs, 2,775 clinicians
St Lukes Physician Group IncGroup PAC ID 6709798333, 2,161 clinicians

Practice addresses (Care Compare)

100 Paramount Blvd
Orwigsburg, PA 17961-2202
Phone (484) 526-2440

2000 Westinghouse Dr
Suite 200
Cranberry Township, PA 16066-5238

4311 Easton Ave
Bethlehem, PA 18020-1431
Phone (610) 954-3600

4379 Easton Ave
101 Family Prac Palmer
Bethlehem, PA 18020-1431
Phone (610) 814-2424

530 Centre St
Ashland, PA 17921-1330
Phone (570) 645-1670

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

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Gslpg, Inc CurrentSince Jul 11, 2023 Accepting new patients
St. Luke's Physician Group, Inc. Family Medicine Current Accepting new patients
St Luke's Physician Group Inc Family Medicine CurrentSince Jul 11, 2023 Accepting new patients
St. Luke's Physician Group, Inc Family Medicine CurrentSince Jul 11, 2023 Accepting new patients
Gslpg Inc Family Medicine Past Accepting new patients

Locations

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

1700 St Lukes Blvd
Easton, PA 18045
Phone (484) 526-4838

1700 St Lukes Blvd
Ofc
Easton, PA 18045
Phone (484) 356-5048

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

100 Paramount Blvd
Orwigsburg, PA 17961
Phone (272) 639-1000

2650 Woodglen Rd
Pottsville, PA 17901
Phone (272) 639-5755

Interoperability endpoints

  • Direct secure messaging: michaela.ortiz@slpg.direct-sluhn.org

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 36

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

View all 36

NPI Registry JSON

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

{
    "created_epoch": "1587945600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737504000000",
    "number": "1023638442",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2650 WOODGLEN RD",
            "city": "POTTSVILLE",
            "state": "PA",
            "postal_code": "179011324",
            "telephone_number": "272-639-5755"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2650 WOODGLEN RD",
            "city": "POTTSVILLE",
            "state": "PA",
            "postal_code": "179011324",
            "telephone_number": "272-639-5755"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAVARIA",
        "first_name": "MICHAELA",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-04-27",
        "last_updated": "2025-01-22",
        "certification_date": "2025-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "OS022975",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pottsville, PA

Sources for this page

Verify at the official NPI Registry.