NPIMap

Individual provider Active NPI

Brian K Kephart, PHYSICIAN ASSISTANT

  • Physician Assistant
  • Allentown, PA
National Provider Identifier
1093709099
Registry record updated Jul 31, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
MA051154 Issued in PA
Practice address
250 Cetronia Road
Suite 303
Allentown, PA 18104-9168
Phone
(610) 973-6200
Fax
(610) 973-6546
NPI assigned
Sep 6, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2009

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X MA051154 PA Primary
Medical Physician Assistant 363AM0700X MA051154 PA
Surgical Physician Assistant 363AS0400X MA051154 PA

Addresses

Primary practice location

250 Cetronia Road
Suite 303
Allentown, PA 18104-9168

Mailing address

PO Box 848269
Boston, MA 02284-8269
Phone (610) 973-1700

Other identifiers 2

IdentifierTypeStateIssuer
50035046OtherPABLUE CROSS
970030742OtherPARAILROAD MEDICARE

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
I20060913000501 PA Practitioner - Physician Assistant 0042214645 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Phoenix Rehabilitation and Health Services IncGroup PAC ID 3476464298, shared by 2 NPIs, 2,775 clinicians

Practice addresses (Care Compare)

2000 Westinghouse Dr
Suite 200
Cranberry Township, PA 16066-5238

250 Cetronia Rd
Suite 303
Allentown, PA 18104-9168
Phone (610) 973-6200

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
85.37 of 100Reported as group
Quality
72.6
Promoting interoperability
100
Improvement activities
40
Cost
78.63

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
MA051154PAMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
St Luke'S Physician Group Inc CurrentSince May 22, 2017 Accepting new patients
Orthopaedic Associates of Allentown CurrentSince Nov 19, 2015 Accepting new patients
St. Luke'S Physician Group, Inc. CurrentSince May 22, 2017 Accepting new patients
Orthopaedic Associates of Allentown Past Accepting new patients

Locations

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

250 Cetronia Rd
Ste 303
Allentown, PA 18104

2045 Westgate Dr
Ste 101
Bethlehem, PA 18017
Phone (610) 868-6353

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

1241 Blakeslee Boulevard Dr E
Lehighton, PA 18235
Phone (570) 386-6900

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 and National Provider Directory roles.

Hospital & facility affiliations 6

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": "1125964800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1248998400000",
    "number": "1093709099",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 848269",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022848269",
            "telephone_number": "610-973-1700",
            "fax_number": "610-973-1778"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 CETRONIA ROAD",
            "address_2": "SUITE 303",
            "city": "ALLENTOWN",
            "state": "PA",
            "postal_code": "181049168",
            "telephone_number": "610-973-6200",
            "fax_number": "610-973-6546"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEPHART",
        "first_name": "BRIAN",
        "middle_name": "K",
        "credential": "PHYSICIAN ASSISTANT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-06",
        "last_updated": "2009-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA051154",
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "PA",
            "license": "MA051154",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "PA",
            "license": "MA051154",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "50035046",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "970030742",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Allentown, PA

Sources for this page

Verify at the official NPI Registry.