Individual provider Active NPI

Guillermo Antonio De la Vega, MD

  • Obstetrics & Gynecology Physician
  • Allentown, PA
National Provider Identifier
1083780761
Registry record updated Jun 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
MD429959 Issued in PA
Practice address
1611 Pond Road
Suite 401
Allentown, PA 18104
Phone
(610) 398-7700
Fax
(610) 398-6917
NPI assigned
Nov 27, 2006
Last updated
Jun 12, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X MD429959 PA Primary

Addresses

Primary practice location

1611 Pond Road
Suite 401
Allentown, PA 18104

Mailing address

PO Box 783311
Philadelphia, PA 19178-3311
Phone (484) 884-4500

Other identifiers 1

IdentifierTypeStateIssuer
108650KZKMedicaidPA

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070208000134 PA Practitioner - Obstetrics/Gynecology 5294737037 Reassigns benefits to 7 organizations

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lehigh Valley Physician GroupGroup PAC ID 3072425123, 2,512 clinicians

Practice addresses (Care Compare)

1431 Nursery St
202 LVPG Obstetrics and Gynegology
Fogelsville, PA 18051-1612
Phone (484) 273-4377

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Schuylkill Health System Medical Group, Inc. CurrentSince Sep 14, 2022 Accepting new patients
Wellspan Medical Group CurrentSince Sep 1, 2021 Accepting new patients
Lehigh Valley Physician Group CurrentSince Jun 1, 2007 Accepting new patients
Family Care Centers Inc CurrentSince Jun 1, 2023 Accepting new patients
Temple Faculty Practice Plan Inc CurrentSince Feb 1, 2025 Accepting new patients
Lehigh Valley Physician Group Obstetrics & Gynecology Current Accepting new patients
Schuylkill Health System Medical Group, Inc. Obstetrics & Gynecology CurrentSince Sep 14, 2022 Accepting new patients
Family Care Centers Inc. Obstetrics & Gynecology CurrentSince Jun 1, 2023 Accepting new patients
Wellspan Medical Group Current Accepting new patients
Valley Health Partners Community Health Center Obstetrics & Gynecology Current Accepting new patients
Temple Faculty Practice Plan, Inc CurrentSince Feb 1, 2025 Accepting new patients
Temple Faculty Practice Plan Inc Current Accepting new patients
Lehigh Valley Physician Group CurrentSince Jun 1, 2007 Accepting new patients
Lehigh Valley Physician Group CurrentSince May 12, 2021 Accepting new patients
Hazleton Professional Services Current Accepting new patients
Wellspan Medical Group CurrentSince Sep 1, 2021 Accepting new patients
Lehigh Valley Hospital Past Accepting new patients
Pulmonary Associates PC Past Accepting new patients
The Good Samaritan Hospital of Lebanon, Pennsylvania Past Accepting new patients
Lehigh Valley Hospital Hazleton Past Accepting new patients
Temple University Hospital, Inc Past Accepting new patients
Temple University Hospital, Inc Past Accepting new patients

Locations

1611 Pond Rd
Ste 401
Allentown, PA 18104
Phone (610) 398-7700

1627 Chew St
Fl 1
Allentown, PA 18102
Phone (610) 969-2800

206 E Brown St
East Stroudsburg, PA 18301
Phone (570) 420-4951

500 Plaza Ct
East Stroudsburg, PA 18301
Phone (570) 426-2330

1431 Nursery St
Ste 202
Fogelsville, PA 18051
Phone (484) 273-4377

1000 Alliance Dr
Hazleton, PA 18202
Phone (570) 501-6400

1000 Alliance Dr
#10
Hazleton, PA 18202
Phone (570) 501-6450

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

3401 N Broad St
Philadelphia, PA 19140
Phone (215) 707-3807

525 Jamestown St
Philadelphia, PA 19128
Phone (215) 482-7970

171 Red Horse Rd
Pottsville, PA 17901
Phone (570) 628-2229

700 Schuylkill Manor Rd
Ste 3
Pottsville, PA 17901
Phone (570) 621-4440

642 State Route 93 Hwy
Ste 1
Sugarloaf, PA 18249
Phone (570) 708-1505

1600 S George St
York, PA 17403
Phone (717) 848-3615

25 Monument Rd
Ste 270
York, PA 17403
Phone (717) 741-8250

Interoperability endpoints

  • Direct secure messaging: gdelavega11559@direct2.lvhn.org
  • Direct secure messaging: ldelavega290549@wellspan.direct-ci.com

Organizations & group practices 24

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.

View all 24

Hospital & facility affiliations 5

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": "1164585600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686528000000",
    "number": "1083780761",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 783311",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191783311",
            "telephone_number": "484-884-4500",
            "fax_number": "484-884-0699"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1611 POND ROAD",
            "address_2": "SUITE 401",
            "city": "ALLENTOWN",
            "state": "PA",
            "postal_code": "18104",
            "telephone_number": "610-398-7700",
            "fax_number": "610-398-6917"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DE LA VEGA",
        "first_name": "GUILLERMO",
        "middle_name": "ANTONIO",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-27",
        "last_updated": "2023-06-12",
        "certification_date": "2023-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "PA",
            "license": "MD429959",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "108650KZK",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Allentown, PA

Sources for this page

Verify at the official NPI Registry.