Individual provider Active NPI

Linda Dallas, M.ED

  • Audiologist
  • Mineola, NY
National Provider Identifier
1164613055
Registry record updated Jan 17, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
002128-1 Issued in NY
Practice address
259 1St St
Mineola, NY 11501-3957
Phone
(856) 702-6100
Fax
(856) 396-0406
NPI assigned
Aug 6, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 17, 2011

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X 002128-1 NY Primary
Audiologist 231H00000X AT000679L PA
Audiologist 231H00000X 000459 CT

Addresses

Primary practice location

259 1St St
Mineola, NY 11501-3957

Mailing address

108 Centre Blvd
Suite I
Marlton, NJ 08053-4132
Phone (856) 702-6100

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081027000373 PA Practitioner - Qualified Audiologist 9537227129 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Qualified Audiologist
Education
Other, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Lukes Physician Group IncGroup PAC ID 6709798333, 2,161 clinicians
Specialty Physician Associates, LLCGroup PAC ID 6204012016, 43 clinicians

Practice addresses (Care Compare)

325 N 5TH St
FL 3
Allentown, PA 18102-3367
Phone (610) 776-4512

3445 High Point Blvd
Suite 400
Bethlehem, PA 18017-7808

3445 High Point Blvd
Suite 400
Bethlehem, PA 18017-7817
Phone (610) 866-5555

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Education

State licenses

LicenseStateTypeSpecialty
000459CTMDChiropractor
002128-1NYMDAudiologist

Practice roles

OrganizationSpecialtyStatusNew patients
St Luke'S Physician Group Inc CurrentSince Jul 1, 2019 Accepting new patients
St. Luke'S Physician Group, Inc. Current Accepting new patients
Specialty Physician Associates, LLC CurrentSince May 2, 2011 Accepting new patients
St. Luke'S Physician Group, Inc. CurrentSince Jul 1, 2019 Accepting new patients
Otorhinolaryngology Associates, P.C. PastSince Mar 12, 2009 Accepting new patients

Locations

325 N 5th St
Fl 3
Allentown, PA 18102
Phone (610) 776-4928

3445 High Point Blvd
Ste 400
Bethlehem, PA 18017
Phone (610) 824-5050

801 Ostrum St
Fountain Hill, PA 18015
Phone (610) 954-2200

217 Franklin Ave
Ste 100
Palmerton, PA 18071
Phone (610) 824-5050

Interoperability endpoints

  • FHIR API: https://fhir.fhirpoint.open.allscripts.com/fhirroute/open/76651

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1186358400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1295222400000",
    "number": "1164613055",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "108 CENTRE BLVD",
            "address_2": "SUITE I",
            "city": "MARLTON",
            "state": "NJ",
            "postal_code": "080534132",
            "telephone_number": "856-702-6100",
            "fax_number": "856-396-0406"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "259 1ST ST",
            "city": "MINEOLA",
            "state": "NY",
            "postal_code": "115013957",
            "telephone_number": "856-702-6100",
            "fax_number": "856-396-0406"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DALLAS",
        "first_name": "LINDA",
        "credential": "M.ED",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-08-06",
        "last_updated": "2011-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "NY",
            "license": "002128-1",
            "primary": true
        },
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "PA",
            "license": "AT000679L",
            "primary": false
        },
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "CT",
            "license": "000459",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mineola, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2011; 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.