NPIMap

Individual provider Active NPI

Alisa Bolton

  • Certified Registered Nurse Anesthetist
  • Bethlehem, PA
National Provider Identifier
1063194603
Registry record updated Dec 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
RN696039 Issued in PA
Practice address
2545 Schoenersville Rd
Bethlehem, PA 18017-7300
Phone
(610) 402-6164
NPI assigned
Aug 3, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 11, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X RN696039 PA Primary

Addresses

Primary practice location

2545 Schoenersville Rd
Bethlehem, PA 18017-7300

Mailing address

1330 Powell St
Norristown, PA 19401-3353
Phone (484) 622-7280

Other practice location 1

1330 Powell St
Norristown, PA 19401-3353
Phone (484) 622-7280

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241217001618 PA Practitioner - Certified Registered Nurse Anesthetist (Crna) 8224565155 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Anesthesia Specialists of Bethlehem PCGroup PAC ID 1355254533, 283 clinicians
Lehigh Valley Physician GroupGroup PAC ID 3072425123, 2,512 clinicians

Practice addresses (Care Compare)

1872 St Lukes Blvd
Easton, PA 18045-5669
Phone (866) 785-8537

330 Main St
Dickson City, PA 18519-1691
Phone (610) 402-6164

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
RN696039PAMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Lehigh Valley Physician Group CurrentSince Dec 23, 2024 Accepting new patients
Lehigh Valley Physician Group CurrentSince Dec 23, 2024 Accepting new patients
Lehigh Valley Physician Group Current Accepting new patients

Locations

2100 Mack Blvd
Fl 4
Allentown, PA 18103

2545 Schoenersville Rd
Bethlehem, PA 18017
Phone (484) 884-2888

1109 Grosser Rd
Gilbertsville, PA 19525
Phone (484) 498-6060

5649 Wynnewood Dr
Ste 104
Laurys Station, PA 18059
Phone (610) 262-6641

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

330 Main St
Scranton, PA 18519
Phone (570) 330-5000

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 13

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

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1691020800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733875200000",
    "number": "1063194603",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1330 POWELL ST",
            "city": "NORRISTOWN",
            "state": "PA",
            "postal_code": "194013353",
            "telephone_number": "484-622-7280"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2545 SCHOENERSVILLE RD",
            "city": "BETHLEHEM",
            "state": "PA",
            "postal_code": "180177300",
            "telephone_number": "610-402-6164"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1330 Powell St",
            "address_purpose": "LOCATION",
            "city": "Norristown",
            "state": "PA",
            "postal_code": "194013353",
            "country_code": "US",
            "telephone_number": "484-622-7280",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOLTON",
        "first_name": "ALISA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-08-03",
        "last_updated": "2024-12-11",
        "certification_date": "2024-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "PA",
            "license": "RN696039",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Dec 11, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.