NPIMap

Individual provider Active NPI

Mary Ellen Williams, D.O.

  • Family Medicine Physician
  • Whitehall, PA
National Provider Identifier
1093855793
Registry record updated Jul 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
OS008484L Issued in PA
Practice address
3691 Crescent CT E Ste 201
Whitehall, PA 18052-3433
Phone
(610) 434-9561
NPI assigned
Feb 8, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 19, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X OS008484L PA Primary

Addresses

Primary practice location

3691 Crescent CT E Ste 201
Whitehall, PA 18052-3433

Mailing address

4801 Saucon Creek Rd
Ste 110
Center Valley, PA 18034-9068
Phone (610) 625-2010

Other practice location 1

1003 Chestnut St
Emmaus, PA 18049-1902
Phone (610) 625-2010

Other identifiers 1

IdentifierTypeStateIssuer
0016773350004MedicaidPA

Other names 1

  • Maryellen W Kistler-Strout Former name

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
I20090508000241 PA Practitioner - Family PracticePractitioner - Osteopathic Manipulative Medicine 8325196975 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Osteopathic Manipulative Medicine
Education
Philadelphia College of Osteopathic Medicine, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Lehigh Valley Physician GroupGroup PAC ID 3072425123, 2,512 clinicians

Practice addresses (Care Compare)

3691 Cresent CT E
LVPG Family Medicine Whitehall
Whitehall, PA 18052-3498
Phone (610) 434-9561

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Lehigh Valley Physician Group Family Medicine CurrentSince Jul 24, 2023 Accepting new patients
Lehigh Valley Physician Group Family Medicine Current Accepting new patients
Lehigh Valley Physician Group CurrentSince Jul 24, 2023 Accepting new patients

Locations

421 Chew St
Allentown, PA 18102
Phone (610) 776-4500

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

3691 Crescent Ct E
Whitehall, PA 18052
Phone (610) 434-9561

3691 Crescent Ct E
Ste 201
Whitehall, PA 18052
Phone (610) 434-9561

Interoperability endpoints

  • Direct secure messaging: mwilliams15360@direct2.lvhn.org

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 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": "1170892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689724800000",
    "number": "1093855793",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4801 SAUCON CREEK RD",
            "address_2": "STE 110",
            "city": "CENTER VALLEY",
            "state": "PA",
            "postal_code": "180349068",
            "telephone_number": "610-625-2010",
            "fax_number": "610-625-2314"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3691 CRESCENT CT E STE 201",
            "city": "WHITEHALL",
            "state": "PA",
            "postal_code": "180523433",
            "telephone_number": "610-434-9561"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1003 Chestnut St",
            "address_purpose": "LOCATION",
            "city": "Emmaus",
            "state": "PA",
            "postal_code": "180491902",
            "country_code": "US",
            "telephone_number": "610-625-2010",
            "fax_number": "610-625-2314",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "MARY ELLEN",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-08",
        "last_updated": "2023-07-19",
        "certification_date": "2023-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "OS008484L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0016773350004",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARYELLEN",
            "last_name": "KISTLER-STROUT",
            "middle_name": "W",
            "credential": "D.O.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Whitehall, PA

Sources for this page

Verify at the official NPI Registry.