NPIMap

Organization Active NPI

Valley Kidney Specialists, P.C.

  • Nephrology Physician
  • Allentown, PA
National Provider Identifier
1134419385
Registry record updated Dec 26, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
Legal business name
VALLEY KIDNEY SPECIALISTS, P.C.
Practice address
1230 S Cedar Crest Blvd
Suite 301
Allentown, PA 18103-6231
Phone
(610) 432-4529
Fax
(610) 432-2206
NPI assigned
Apr 8, 2011
Last updated
Dec 26, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 26, 2013

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

Authorized official

Name
Dr. Ravindra Bollu, M.D.NPI 1194716845
Title
President
Phone
(610) 432-4529

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RN0300X Primary

Addresses

Primary practice location

1230 S Cedar Crest Blvd
Suite 301
Allentown, PA 18103-6231

Mailing address

1230 S Cedar Crest Blvd
Suite 301
Allentown, PA 18103-6231
Phone (610) 432-4529

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, NJ2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20110623000259 PA Part B Supplier - Clinic/Group Practice 2860670734 Receives reassigned benefits from 34 practitioners
Practice locations: Allentown, PA; Wyomissing, PA; Wind Gap, PA; Sellersville, PA; Pottsville, PA; Lehighton, PA; Easton, PA; Kutztown, PA…
O20111129000481 NJ Part B Supplier - Clinic/Group Practice 2860670734 Receives reassigned benefits from 9 practitioners
Practice locations: Phillipsburg, NJ

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
39D0190946Valley Kidney Specialists, PC1230 S Cedar Crest Blvd #301, Allentown, PA 18103Provider-performed microscopyAug 31, 2026
39D2067928Valley Kidney Specialists, PC1230 S Cedar Crest Blvd Suite 302, Allentown, PA 18103Provider-performed microscopyOct 23, 2027

National Provider Directory

National Provider Directory

Member organizations 5

Organizations listed as members of this organization in the National Provider Directory.

Locations

185 Roseberry St
#2
Phillipsburg, NJ 08865

1230 S Cedar Crest Blvd
#30230
Allentown, PA 18103

1230 S Cedar Crest Blvd
Ste 203
Allentown, PA 18103

1230 S Cedar Crest Blvd
Ste 30130
Allentown, PA 18103

1230 S Cedar Crest Blvd
Ste 304
Allentown, PA 18103
Phone (452) 961-0432

125 S Courtland St
East Stroudsburg, PA 18301
Phone (570) 476-1606

50 S 18th St
Easton, PA 18042
Phone (610) 250-9794

168 S Sgt Stanley Hoffman Blvd
Lehighton, PA 18235
Phone (610) 377-2311

1105 Bethlehem Pike
#5B
Sellersville, PA 18960

1105 Bethlehem Pike
Unit 85
Sellersville, PA 18960

1105 Bethlehem Pike
Unit B
Sellersville, PA 18960

55 N 3rd St
Stroudsburg, PA 18360
Phone (570) 424-9443

Practitioners & affiliated clinicians

Practitioners 45

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 45

NPI Registry JSON

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

{
    "created_epoch": "1302220800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1388016000000",
    "number": "1134419385",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1230 S CEDAR CREST BLVD",
            "address_2": "SUITE 301",
            "city": "ALLENTOWN",
            "state": "PA",
            "postal_code": "181036231",
            "telephone_number": "610-432-4529",
            "fax_number": "610-432-2206"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1230 S CEDAR CREST BLVD",
            "address_2": "SUITE 301",
            "city": "ALLENTOWN",
            "state": "PA",
            "postal_code": "181036231",
            "telephone_number": "610-432-4529",
            "fax_number": "610-432-2206"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VALLEY KIDNEY SPECIALISTS, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-04-08",
        "last_updated": "2013-12-26",
        "status": "A",
        "authorized_official_last_name": "BOLLU",
        "authorized_official_first_name": "RAVINDRA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "610-432-4529",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Nephrology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Allentown, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 26, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.