Individual provider Active NPI

Stephen Deturk, CRNA

  • Certified Registered Nurse Anesthetist
  • Allentown, PA
National Provider Identifier
1083696348
Registry record updated Jul 27, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
RN200328L Issued in PA
Practice address
1736 W Hamilton St
Allentown, PA 18104-5656
Phone
(610) 628-8372
Fax
(610) 628-8648
NPI assigned
Nov 14, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 27, 2007

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 RN200328L PA Primary

Addresses

Primary practice location

1736 W Hamilton St
Allentown, PA 18104-5656

Mailing address

24 S 18TH St
Allentown, PA 18104-5622
Phone (610) 628-8372

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050610000107 PA Practitioner - Certified Registered Nurse Anesthetist (Crna) 0345283321 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 1976
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northeastern Anesthesia Physicians P.C. 14 clinicians

Practice addresses (Care Compare)

1736 Hamilton St
Allentown, PA 18104-5656
Phone (610) 770-8372

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Northeastern Anesthesia Physicians P.C. CurrentSince Oct 4, 1996 Accepting new patients

Locations

1736 Hamilton St
Allentown, PA 18104
Phone (610) 770-8300

250 Cetronia Rd
Ste 300
Allentown, PA 18104
Phone (484) 223-2880

24 S 18th St
Allentown, PA 18104
Phone (610) 628-8372

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1131926400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1185494400000",
    "number": "1083696348",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24 S 18TH ST",
            "city": "ALLENTOWN",
            "state": "PA",
            "postal_code": "181045622",
            "telephone_number": "610-628-8372",
            "fax_number": "610-628-8648"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1736 W HAMILTON ST",
            "city": "ALLENTOWN",
            "state": "PA",
            "postal_code": "181045656",
            "telephone_number": "610-628-8372",
            "fax_number": "610-628-8648"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DETURK",
        "first_name": "STEPHEN",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-14",
        "last_updated": "2007-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "PA",
            "license": "RN200328L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Allentown, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2007; 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.