St. Luke'S Physician Group Inc
Organization Active NPI Family Medicine Physician · Lehighton, PA
NPI 1194196402 · NPPES record last updated Apr 23, 2025
Key facts
- NPI
- 1194196402
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Family Medicine Physician 207Q00000X
- Legal business name
- ST. LUKE'S PHYSICIAN GROUP INC
- Practice address
- 770 State Rd
Lehighton, PA 18235-2857 - Phone
- (610) 377-9020
- Fax
- (610) 377-9784
- NPI assigned
- Oct 13, 2015
- Organization subpart
- No
Authorized official
- Name
- Joseph Minahan
- Title
- President
- Phone
- (484) 526-3383
Corporate family (same tax ID) 24
Practitioners 6
-
Tiffany Chit, MD
-
Troy Hamilton Cover, M.D.
-
Peter Bate Ojong, CRNP
-
Celeste Marie Truckenmiller, FNP-BC
-
Amy W Doolan, D.O.
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 39D1016064 | St Luke'S Lehighton Family Practice | Certificate of waiver | Aug 18, 2027 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in PA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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
- Tax ID family
- Upper Bucks Emergency M
Locations
530 W Center St
Ashland, PA 17921
Phone (570) 645-1670
1254 Interchange Rd
Lehighton, PA 18235
Phone (484) 426-2050
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician |
207Q00000X | PA | Yes |
Addresses
Primary practice location
770 State Rd
Lehighton, PA 18235-2857
Mailing address
770 State Rd
Lehighton, PA 18235-2857
Phone (610) 377-9020
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 686024 | Other | PA | MEDICARE GROUP |
Other names
- St. Luke's Lehighton Family Practice
Other providers in Lehighton, PA
- St. Luke'S Hospital
- St. Luke'S Hospital
- St. Luke'S Hospital Bethlehem
- St. Luke'S Hospital Bethlehem
- St. Luke'S Hospital-Carbon Campus
- 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 Lehighton, PA · Family Medicine Physician in Pennsylvania
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 23, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.