NPIMap

Individual provider Active NPI

Alexandros Dimitriadis, PA-C

  • Physician Assistant
  • Palmerton, PA
National Provider Identifier
1083162671
Registry record updated Feb 23, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
MA058485 Issued in PA
Practice address
255 Delaware Ave
Palmerton, PA 18071-1812
Phone
(610) 826-4595
Fax
(610) 826-4399
NPI assigned
Sep 13, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 23, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X MA058485 PA Primary

Addresses

Primary practice location

255 Delaware Ave
Palmerton, PA 18071-1812

Mailing address

255 Delaware Ave
Palmerton, PA 18071-1812
Phone (610) 826-4595

Other identifiers 1

IdentifierTypeStateIssuer
1033791750001MedicaidPA

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
I20170524000063 PA Practitioner - Physician Assistant 2163799107 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2016
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)

211 N 12 St
Lehighton, PA 18235-1138

255 Delaware Ave
Palmerton, PA 18071-1812
Phone (610) 826-4595

360 W Riddle St
Coaldale, PA 18218-1027

500 St Lukes Dr
Lehighton, PA 18235-5000
Phone (484) 526-2200

801 Ostrm St
Bethlehem, PA 18015-1000

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
Physician Assistant

State licenses

LicenseStateTypeSpecialty
MA058485PAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
St Luke's Physician Group Inc CurrentSince Oct 1, 2018 Accepting new patients
St. Luke's Physician Group, Inc. CurrentSince Oct 1, 2018 Accepting new patients
St. Luke's Physician Group, Inc. Past Accepting new patients

Locations

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

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

255 Delaware Ave
Palmerton, PA 18071
Phone (610) 826-4302

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 9

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": "1473724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1771804800000",
    "number": "1083162671",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "255 DELAWARE AVE",
            "city": "PALMERTON",
            "state": "PA",
            "postal_code": "180711812",
            "telephone_number": "610-826-4595"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "255 DELAWARE AVE",
            "city": "PALMERTON",
            "state": "PA",
            "postal_code": "180711812",
            "telephone_number": "610-826-4595",
            "fax_number": "610-826-4399"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIMITRIADIS",
        "first_name": "ALEXANDROS",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-09-13",
        "last_updated": "2026-02-23",
        "certification_date": "2026-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA058485",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1033791750001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Palmerton, PA

Sources for this page

Verify at the official NPI Registry.