NPIMap

Organization Active NPI

St. Luke's Physician Group, Inc

Doing business as St. Luke's General Surgery Monroe

  • Surgery Physician
  • Bartonsville, PA
National Provider Identifier
1104483411
Registry record updated Aug 25, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
Legal business name
ST. LUKE'S PHYSICIAN GROUP, INC
Doing business as
St. Luke's General Surgery Monroe
Practice address
3565 Route 611 Ste 300
Bartonsville, PA 18321-7800
Phone
(484) 526-2200
Fax
(484) 526-2398
NPI assigned
May 22, 2019
Last updated
Aug 25, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 25, 2021

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

Authorized official

Name
Tami Giglio
Title
Enrollment Specialist
Phone
(484) 526-3571

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X NU Primary
Surgical Critical Care Physician 2086S0102X NU

Addresses

Primary practice location

3565 Route 611 Ste 300
Bartonsville, PA 18321-7800

Mailing address

801 Ostrum St
Bethlehem, PA 18015-1000
Phone (484) 526-3571

Other identifiers 1

IdentifierTypeStateIssuer
034134OtherPAMEDICARE

Other names 1

  • St. Luke's General Surgery Monroe Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040226000062 PA Part B Supplier - Clinic/Group Practice 6709798333 Receives reassigned benefits from 3,523 practitioners
This NPI is an additional NPI on the enrollment

National Provider Directory

National Provider Directory

Locations

3565 Route 611
Ste 300
Bartonsville, PA 18321
Phone (272) 212-0105

Practitioners & affiliated clinicians

Practitioners 17

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1558483200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1629849600000",
    "number": "1104483411",
    "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": "484-526-3571",
            "fax_number": "833-213-6428"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3565 ROUTE 611 STE 300",
            "city": "BARTONSVILLE",
            "state": "PA",
            "postal_code": "183217800",
            "telephone_number": "484-526-2200",
            "fax_number": "484-526-2398"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST. LUKE'S PHYSICIAN GROUP, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-05-22",
        "last_updated": "2021-08-25",
        "certification_date": "2021-08-25",
        "status": "A",
        "authorized_official_last_name": "GIGLIO",
        "authorized_official_first_name": "TAMI",
        "authorized_official_title_or_position": "ENROLLMENT SPECIALIST",
        "authorized_official_telephone_number": "484-526-3571"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "2086S0102X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgical Critical Care",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "034134",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "St. Luke's General Surgery Monroe",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "St. Luke's General Surgery Monroe",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bartonsville, PA

Sources for this page

  • 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.