St. Luke'S Physician Group, Inc.

Primary specialty

Trauma Surgery PhysicianTaxonomy code 2086S0127X

Legal business name

ST. LUKE'S PHYSICIAN GROUP, INC.

Practice address

801 Ostrum St
Bethlehem, PA 18015-1000

Phone

(484) 526-2200

Fax

(484) 526-6459

NPI assigned

Nov 22, 2006

Organization subpart

No

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

Authorized official

Name

Sue Chiavaroli

Title

Cvo Supervisor

Phone

(484) 526-3569

Specialties & licenses 3

Addresses

Other identifiers 1

Other names 1

• St. Luke's Trauma Associates Doing business as

Medicare fee-for-service enrollment

Enrolled in PA

Enrollment records 1

Locations

Practitioners 30

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Humza Ahmed, DO

  • Emergency Medicine Physician
  • Easton, PA
  • NPI 1598468720

  Emergency Medicine

  NPD
• Patrick J Brogle, MD

  • Orthopaedic Surgery Physician
  • Bethlehem, PA
  • NPI 1700840527
  NPD
• Zachary Arthur Frenzel, MD

  • Trauma Surgery Physician
  • Sellersville, PA
  • NPI 1104311109

  Surgical Critical Care

  NPD
• Patrick Gregory, DO

  • Emergency Medicine Physician
  • Easton, PA
  • NPI 1700521176

  Emergency Medicine

  NPD
• Dilshan N Gunawardena, MD, DMD, FACS

  • Oral & Maxillofacial Surgery (D.M.D.)
  • Warminster, PA
  • NPI 1982864492
  NPD
• Prabhdeep Hehar, D.O

  • Critical Care Medicine (Anesthesiology) Physician
  • Bethlehem, PA
  • NPI 1457714792
  NPD
• Assabi A Isaac, D.D.S.

  • Oral and Maxillofacial Surgery (Dentist)
  • Bethlehem, PA
  • NPI 1831471028
  NPD
• Laura Carol Longman, DO

  • Emergency Medicine Physician
  • Stroudsburg, PA
  • NPI 1578207858

  Emergency Medicine

  NPD
• Ian Michaels, PAC

  • Physician Assistant
  • Easton, PA
  • NPI 1467288746
  NPD
• W. Michael Morrissey Jr., MD

  • Plastic and Reconstructive Surgery Physician
  • Bethlehem, PA
  • NPI 1831178649
  NPD
• Troy Quail, MD

  • Emergency Medicine Physician
  • Easton, PA
  • NPI 1740967918

  Emergency Medicine

  NPD
• Mihai Radulescu, DMD

  • Oral and Maxillofacial Surgery (Dentist)
  • Danville, PA
  • NPI 1679861942
  NPD

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

{
    "created_epoch": "1164153600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1629849600000",
    "number": "1083789150",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 OSTRUM ST",
            "city": "BETHLEHEM",
            "state": "PA",
            "postal_code": "180151000",
            "telephone_number": "484-526-2200",
            "fax_number": "484-526-6459"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 OSTRUM ST",
            "city": "BETHLEHEM",
            "state": "PA",
            "postal_code": "180151000",
            "telephone_number": "484-526-2200",
            "fax_number": "484-526-6459"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "801 Ostrum St",
            "address_purpose": "LOCATION",
            "city": "Bethlehem",
            "state": "PA",
            "postal_code": "180151000",
            "country_code": "US",
            "telephone_number": "484-526-2200",
            "fax_number": "484-526-6459",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "ST. LUKE'S PHYSICIAN GROUP, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-22",
        "last_updated": "2021-08-25",
        "certification_date": "2021-08-25",
        "status": "A",
        "authorized_official_last_name": "CHIAVAROLI",
        "authorized_official_first_name": "SUE",
        "authorized_official_title_or_position": "CVO SUPERVISOR",
        "authorized_official_telephone_number": "484-526-3569"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Emergency Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2086S0102X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery, Surgical Critical Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2086S0127X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery, Trauma Surgery",
            "state": "PA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1007307530035",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "St. Luke's Trauma Associates",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "St. Luke's Trauma Associates",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• St. Luke'S Physician Group, Inc
• St. Luke'S Physician Group, Inc
• St. Luke'S Physician Group, Inc
• St. Luke'S Physician Group, Inc.
• St. Luke'S Physician Group, Inc.
• St. Luke'S Physician Group, Inc.
• St. Luke'S Physician Group, Inc.
• St. Luke'S Physician Group, Inc.
• St. Luke'S Physician Group, Inc.
• St. Luke'S Physician Group, Inc.

• All providers in Bethlehem, PA
• Trauma Surgery Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2021; 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.