NPIMap

Individual provider Active NPI

Nishanth Vallumsetla

  • Pulmonary Disease Physician
  • Scranton, PA
National Provider Identifier
1134589799
Registry record updated Nov 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
MD490850 Issued in PA
Practice address
300 Lackawanna Ave Ste 200
Scranton, PA 18503-2001
Phone
(570) 342-7864
NPI assigned
Feb 25, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 10, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pulmonary Disease Physician 207RP1001X MD490850 PA Primary
Pulmonary Disease Physician 207RP1001X 0.36159074 IL

Addresses

Primary practice location

300 Lackawanna Ave Ste 200
Scranton, PA 18503-2001

Mailing address

2100 Mack Blvd FL 4
Allentown, PA 18103-5622

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, PA2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20220707002941 IL Practitioner - Pulmonary Disease 7911387964
I20260130000368 PA Practitioner - Pulmonary Disease 7911387964 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pulmonary Disease
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lehigh Valley Physician GroupGroup PAC ID 3072425123, 2,512 clinicians

Practice addresses (Care Compare)

1210 S Cedar Crest Blvd
Allentown, PA 18103-6235
Phone (610) 402-3888

200 E Brown St
LVPG Family Medicine Esu
East Stroudsburg, PA 18301-3006
Phone (272) 762-4378

2100 Mack Blvd
FL 4
Allentown, PA 18103-5622

300 Lackawanna Ave
Scranton, PA 18503-2001
Phone (570) 342-7864

5649 Wynnewood Dr
Laurys Station, PA 18059-1124

Hospital & facility affiliations

  • Lehigh Valley Hospital - Pocono Hospital, East Stroudsburg, PA, CCN 390201
  • Osf Heart of Mary Medical Center Hospital, Urbana, IL, CCN 140113
  • Geisinger Wyoming Valley Medical Center Hospital, Wilkes Barre, PA, CCN 390270

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0.36159074ILMDPulmonary Disease Physician
MD490850PAMDPulmonary Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lehigh Valley Physician Group CurrentSince Nov 10, 2025 Accepting new patients
Lehigh Valley Physician Group CurrentSince Nov 10, 2025 Accepting new patients
Pulmonary Associates PC Pulmonary Disease Past Accepting new patients

Locations

2100 Mack Blvd
Fl 4
Allentown, PA 18103

320 W Pumping Station Rd
Quakertown, PA 18951
Phone (215) 529-4240

300 Lackawanna Ave
Ste 200
Scranton, PA 18503
Phone (570) 342-7864

Organizations & group practices 4

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 24

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1456358400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762732800000",
    "number": "1134589799",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 MACK BLVD FL 4",
            "city": "ALLENTOWN",
            "state": "PA",
            "postal_code": "181035622"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 LACKAWANNA AVE STE 200",
            "city": "SCRANTON",
            "state": "PA",
            "postal_code": "185032001",
            "telephone_number": "570-342-7864"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VALLUMSETLA",
        "first_name": "NISHANTH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-02-25",
        "last_updated": "2025-11-10",
        "certification_date": "2025-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "PA",
            "license": "MD490850",
            "primary": true
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "IL",
            "license": "0.36159074",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Scranton, PA

Sources for this page

Verify at the official NPI Registry.