Individual provider Active NPI

Alexander Ayres Mearhoff-Nickum

  • Nurse Practitioner
  • Easton, PA
National Provider Identifier
1063287910
Registry record updated Dec 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
SP028695 Issued in PA
Practice address
1872 St Lukes Blvd
Easton, PA 18045-5669
Phone
(484) 526-6643
Fax
(484) 526-4658
NPI assigned
Nov 21, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 14, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X SP028695 PA Primary

Addresses

Primary practice location

1872 St Lukes Blvd
Easton, PA 18045-5669

Mailing address

1872 St Lukes Blvd
Easton, PA 18045-5669
Phone (484) 526-6643

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231203000129 PA Practitioner - Nurse Practitioner 5698123545 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Lukes Physician Group IncGroup PAC ID 6709798333, 2,161 clinicians

Practice addresses (Care Compare)

1021 Park Ave
Quakertown, PA 18951-0130

1736 Hamilton St
Allentown, PA 18104-5656
Phone (484) 526-8142

1736 W Hamilton St
Allentown, PA 18104-5656
Phone (610) 954-3571

1872 St Lukes Blvd
Easton, PA 18045-5669
Phone (484) 526-7800

250 S 21St St
Easton, PA 18042-3851

3000 St Lukes Dr
Quakertown, PA 18951-1696
Phone (484) 526-3950

801 Ostrm St
Bethlehem, PA 18015-1000

Hospital & facility affiliations

  • St Lukes Hospital Hospital, Bethlehem, PA, CCN 390049
  • St Luke'S Hospital - Easton Campus Hospital, Easton, PA, CCN 390162
  • St Luke'S Hospital - Upper Bucks Campus Hospital, Quakertown, PA, CCN 390035

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
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
SP028695PAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
St. Luke'S Physician Group, Inc. Current Accepting new patients
St Luke'S Physician Group Inc CurrentSince Nov 26, 2023 Accepting new patients
St. Luke'S Physician Group, Inc. CurrentSince Nov 26, 2023 Accepting new patients
Gslpg, Inc CurrentSince Nov 26, 2023 Accepting new patients

Locations

1872 St Lukes Blvd
Easton, PA 18045
Phone (484) 503-1200

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

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

Interoperability endpoints

  • Direct secure messaging: alex.mearhoff-nickum@slpg.direct-sluhn.org

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.

Hospital & facility affiliations 8

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

NPI Registry JSON

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

{
    "created_epoch": "1700524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702512000000",
    "number": "1063287910",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1872 ST LUKES BLVD",
            "city": "EASTON",
            "state": "PA",
            "postal_code": "180455669",
            "telephone_number": "484-526-6643",
            "fax_number": "484-526-4658"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1872 ST LUKES BLVD",
            "city": "EASTON",
            "state": "PA",
            "postal_code": "180455669",
            "telephone_number": "484-526-6643",
            "fax_number": "484-526-4658"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEARHOFF-NICKUM",
        "first_name": "ALEXANDER",
        "middle_name": "AYRES",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-11-21",
        "last_updated": "2023-12-14",
        "certification_date": "2023-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "PA",
            "license": "SP028695",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Easton, PA

Sources for this page

Verify at the official NPI Registry.