St. Luke'S Physician Group Inc

Primary specialty

Pediatric Surgery PhysicianTaxonomy code 2086S0120X

Legal business name

ST. LUKE'S PHYSICIAN GROUP INC

Practice address

153 Brodhead Rd
Bethlehem, PA 18017-8931

Phone

(610) 954-4975

Fax

(610) 954-6485

NPI assigned

Feb 12, 2007

Organization subpart

No

Name

Dean W Evans

Title

President

Phone

(691) 954-4991

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Nneka Catherine Anagbogu, MD

  • Internal Medicine Physician
  • Bethlehem, PA
  • NPI 1710995394
  NPD
• Shweta Batra

  • Registered Dietitian
  • Center Valley, PA
  • NPI 1477271302
  NPD
• Gregory Mark Bentzinger, D.P.M

  • Foot Surgery Podiatrist
  • Tamaqua, PA
  • NPI 1073602041
  NPD
• Hannah Cheng

  • Physical Medicine & Rehabilitation Physician
  • Bethlehem, PA
  • NPI 1265059158
  NPD
• Deline M Da Costa, MD

  • Anatomic Pathology & Clinical Pathology Physician
  • Bethlehem, PA
  • NPI 1649292764
  NPD
• Bolanle Dada, M.D.

  • Internal Medicine Physician
  • Pottsville, PA
  • NPI 1629099288
  NPD
• Tara Rose Diehl, CRNP

  • Family Nurse Practitioner
  • Bethlehem, PA
  • NPI 1386311686
  NPD
• Calogero Dimaggio, DO

  • Vascular Surgery Physician
  • Orwigsburg, PA
  • NPI 1801929096
  NPD
• Susan Dlugosz, CRNP

  • Nurse Practitioner
  • Philadelphia, PA
  • NPI 1366879124
  NPD
• Glenn S Freed, DO

  • Gastroenterology Physician
  • Pottsville, PA
  • NPI 1407841067
  NPD
• Paul Gulotta, M.D.

  • Cardiovascular Disease Physician
  • Bethlehem, PA
  • NPI 1326114778
  NPD
• Evan Joye, M.D.

  • Advanced Heart Failure and Transplant Cardiology Physician
  • Bethlehem, PA
  • NPI 1407242696
  NPD

Medicare fee-for-service enrollment

Enrolled in PA

Enrollment records 1

Locations

• ST. LUKE'S PEDIATRIC SURGERY Doing business as

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Aug 22, 2020.

{
    "created_epoch": "1171238400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1164563029",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "623 E BROAD ST",
            "address_2": "2ND FLR",
            "city": "BETHLEHEM",
            "state": "PA",
            "postal_code": "180186332",
            "telephone_number": "610-954-6048",
            "fax_number": "610-954-3189"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "153 BRODHEAD RD",
            "city": "BETHLEHEM",
            "state": "PA",
            "postal_code": "180178931",
            "telephone_number": "610-954-4975",
            "fax_number": "610-954-6485"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST. LUKE'S PHYSICIAN GROUP INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-12",
        "last_updated": "2020-08-22",
        "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": "691-954-4991"
    },
    "taxonomies": [
        {
            "code": "2086S0120X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery, Pediatric Surgery",
            "state": "PA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PEDIATRIC SURGERY",
            "identifier": "PEDIATRIC SURGERY",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ST. LUKE'S PEDIATRIC SURGERY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• St. Luke'S Hospital and Health Network
• St. Luke'S Hospital Bethlehem
• St. Luke'S Hospitral Network
• St. Luke'S North Dialysis Center, LP
• St. Luke'S Physician Group Inc
• St. Luke'S Physician Group Inc
• St. Luke'S Physician Group Inc
• St. Luke'S Physician Group Inc
• St. Luke'S Physician Group Inc
• St. Luke'S Physician Group Inc

• All providers in Bethlehem, PA
• Pediatric Surgery Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.