NPIMap

Organization Active NPI

Lehigh Valley Physician Group

Doing business as LVHN Keystone Prosthetics & Orthotics

  • Durable Medical Equipment & Medical Supplies
  • Dickson City, PA
National Provider Identifier
1174257513
Registry record updated May 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
Legal business name
LEHIGH VALLEY PHYSICIAN GROUP
Doing business as
LVHN Keystone Prosthetics & Orthotics
Practice address
334 Main St Ste 220
Dickson City, PA 18519-1668
Phone
(570) 307-4191
Fax
(570) 307-4195
NPI assigned
Jul 12, 2022
Last updated
May 8, 2024By the provider in NPPES
Organization subpart
Yes
Parent organization
LEHIGH VALLEY PHYSICIAN GROUPAs reported in NPPES

NPPES NPI Registry

Updated by the provider on May 8, 2024

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

Authorized official

Name
James Demopoulos
Title
Sr VP & Coo
Phone
(484) 862-3333

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X Primary
Prosthetic/Orthotic Supplier 335E00000X

Addresses

Primary practice location

334 Main St Ste 220
Dickson City, PA 18519-1668

Mailing address

334 Main St Ste 220
Dickson City, PA 18519-1668
Phone (570) 307-4191

Other names 1

  • LVHN Keystone Prosthetics & Orthotics Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040227000335 PA Part B Supplier - Clinic/Group Practice 3072425123 Receives reassigned benefits from 3,502 practitioners
This NPI is an additional NPI on the enrollment
O20230418001379 PA DME Supplier - Orthotic Personnel 3072425123 Practice locations: Dickson City, PA

Other NPIs with the same Medicare PAC ID 3

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

National Provider Directory

National Provider Directory
Tax ID family
Lehigh Vly Phy GP174 organizations share this tax ID, including this one
Part of
Lehigh Vly Phy GP

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

334 Main St
Ste 1
Scranton, PA 18519
Phone (570) 307-1767

334 Main St
Ste 220
Scranton, PA 18519
Phone (570) 307-4191

Practitioners & affiliated clinicians

Practitioners 10

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.

NPI Registry JSON

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

{
    "created_epoch": "1657584000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1715126400000",
    "number": "1174257513",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "334 MAIN ST STE 220",
            "city": "DICKSON CITY",
            "state": "PA",
            "postal_code": "185191668",
            "telephone_number": "570-307-4191",
            "fax_number": "570-307-4195"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "334 MAIN ST STE 220",
            "city": "DICKSON CITY",
            "state": "PA",
            "postal_code": "185191668",
            "telephone_number": "570-307-4191",
            "fax_number": "570-307-4195"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEHIGH VALLEY PHYSICIAN GROUP",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "LEHIGH VALLEY PHYSICIAN GROUP",
        "enumeration_date": "2022-07-12",
        "last_updated": "2024-05-08",
        "certification_date": "2024-05-08",
        "status": "A",
        "authorized_official_last_name": "DEMOPOULOS",
        "authorized_official_first_name": "JAMES",
        "authorized_official_title_or_position": "SR VP & COO",
        "authorized_official_telephone_number": "484-862-3333"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "LVHN Keystone Prosthetics & Orthotics",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "LVHN Keystone Prosthetics & Orthotics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Dickson City, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2024; 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.