NPIMap

Organization Active NPI

St. Luke's Physician Group Inc.

Doing business as St. Luke's Family Practice

  • Family Medicine Physician
  • Bethlehem, PA
National Provider Identifier
1083092019
Registry record updated May 14, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
ST. LUKE'S PHYSICIAN GROUP INC.
Doing business as
St. Luke's Family Practice
Practice address
2830 Easton Ave
Bethlehem, PA 18017-4204
Phone
(484) 526-3555
Fax
(484) 526-3560
NPI assigned
May 11, 2015
Last updated
May 14, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 14, 2015

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

Authorized official

Name
Dean W Evans
Title
President
Phone
(484) 526-4991

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

2830 Easton Ave
Bethlehem, PA 18017-4204

Mailing address

2830 Easton Ave
Bethlehem, PA 18017-4204
Phone (484) 526-3555

Other names 1

  • St. Luke's Family Practice Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040226000062 PA Part B Supplier - Clinic/Group Practice 6709798333 Receives reassigned benefits from 3,523 practitioners
This NPI is an additional NPI on the enrollment

National Provider Directory

National Provider Directory
Tax ID family
Orthopaedic Surgical GR165 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Locations

108 Plaza Dr
Ste 101
Blandon, PA 19510
Phone (610) 208-4650

330 N Best Ave
Ste A
Walnutport, PA 18088
Phone (610) 628-8922

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1431302400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1431561600000",
    "number": "1083092019",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2830 EASTON AVE",
            "city": "BETHLEHEM",
            "state": "PA",
            "postal_code": "180174204",
            "telephone_number": "484-526-3555",
            "fax_number": "484-526-3560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2830 EASTON AVE",
            "city": "BETHLEHEM",
            "state": "PA",
            "postal_code": "180174204",
            "telephone_number": "484-526-3555",
            "fax_number": "484-526-3560"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST. LUKE'S PHYSICIAN GROUP INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-05-11",
        "last_updated": "2015-05-14",
        "status": "A",
        "authorized_official_last_name": "EVANS",
        "authorized_official_first_name": "DEAN",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "484-526-4991"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "St. Luke's Family Practice",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 May 14, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.