NPIMap

Organization Active NPI

St. Luke's Physician Group, Inc

Doing business as St. Luke's Nephrology Associates of Monroe County

  • Nephrology Physician
  • Stroudsburg, PA
National Provider Identifier
1134581309
Registry record updated Mar 28, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
Legal business name
ST. LUKE'S PHYSICIAN GROUP, INC
Doing business as
St. Luke's Nephrology Associates of Monroe County
Practice address
1619 N 9TH St
Suite 2a
Stroudsburg, PA 18360-6501
Phone
(610) 628-7920
Fax
(610) 821-2853
NPI assigned
Mar 25, 2016
Last updated
Mar 28, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 28, 2016

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

Authorized official

Name
Dean W. Evans
Title
President
Phone
(484) 526-4991

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X NU Primary

Addresses

Primary practice location

1619 N 9TH St
Suite 2a
Stroudsburg, PA 18360-6501

Mailing address

1619 N 9TH St
Suite 2a
Stroudsburg, PA 18360-6501
Phone (610) 628-7920

Other names 1

  • St. Luke's Nephrology Associates of Monroe County 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
Tax ID family
St Lukes Surgical Assoc165 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Locations

2591 Baglyos Cir
Ste C49
Bethlehem, PA 18020
Phone (484) 503-7300

1619 N 9th St
Ste 2A
Stroudsburg, PA 18360
Phone (610) 628-7920

Practitioners & affiliated clinicians

Practitioners 26

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 26

NPI Registry JSON

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

{
    "created_epoch": "1458864000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1459123200000",
    "number": "1134581309",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1619 N 9TH ST",
            "address_2": "SUITE 2A",
            "city": "STROUDSBURG",
            "state": "PA",
            "postal_code": "183606501",
            "telephone_number": "610-628-7920",
            "fax_number": "610-821-2853"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1619 N 9TH ST",
            "address_2": "SUITE 2A",
            "city": "STROUDSBURG",
            "state": "PA",
            "postal_code": "183606501",
            "telephone_number": "610-628-7920",
            "fax_number": "610-821-2853"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST. LUKE'S PHYSICIAN GROUP, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-03-25",
        "last_updated": "2016-03-28",
        "status": "A",
        "authorized_official_last_name": "EVANS",
        "authorized_official_first_name": "DEAN",
        "authorized_official_middle_name": "W.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "484-526-4991"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "St. Luke's Nephrology Associates of Monroe County",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Stroudsburg, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2016; 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.