NPIMap

Organization Active NPI

St. Luke'S Physician Group, Inc.

  • Pediatric Endocrinology Physician
  • Center Valley, PA
National Provider Identifier
1194306647
Registry record updated Apr 16, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Endocrinology PhysicianTaxonomy code 2080P0205X
Legal business name
ST. LUKE'S PHYSICIAN GROUP, INC.
Practice address
5445 Lanark Rd
Center Valley, PA 18034-8694
Phone
(484) 526-7300
Fax
(866) 449-5832
NPI assigned
Apr 16, 2021
Organization subpart
Yes
Parent organization
ST. LUKE'S PHYSICIAN GROUP, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 16, 2021

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

Authorized official

Name
Sue Chiavaroli
Title
Enrollment Supervisor
Phone
(484) 526-3569

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Endocrinology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2080P0205X Primary

Addresses

Primary practice location

5445 Lanark Rd
Center Valley, PA 18034-8694

Mailing address

77 S Commerce Way
Bethlehem, PA 18017-8891
Phone (484) 526-4999

Other names 1

  • St. Luke's Pediatric Endocrinology Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
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

National Provider Directory
Part of
Upper Bucks Emergency M

Practitioners & affiliated clinicians

Practitioners 45

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

View all 45

NPI Registry JSON

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

{
    "created_epoch": "1618531200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1618531200000",
    "number": "1194306647",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "77 S COMMERCE WAY",
            "city": "BETHLEHEM",
            "state": "PA",
            "postal_code": "180178891",
            "telephone_number": "484-526-4999",
            "fax_number": "833-213-6427"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5445 LANARK RD",
            "city": "CENTER VALLEY",
            "state": "PA",
            "postal_code": "180348694",
            "telephone_number": "484-526-7300",
            "fax_number": "866-449-5832"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST. LUKE'S PHYSICIAN GROUP, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ST. LUKE'S PHYSICIAN GROUP, INC.",
        "enumeration_date": "2021-04-16",
        "last_updated": "2021-04-16",
        "certification_date": "2021-04-16",
        "status": "A",
        "authorized_official_last_name": "CHIAVAROLI",
        "authorized_official_first_name": "SUE",
        "authorized_official_title_or_position": "ENROLLMENT SUPERVISOR",
        "authorized_official_telephone_number": "484-526-3569"
    },
    "taxonomies": [
        {
            "code": "2080P0205X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics, Pediatric Endocrinology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "St. Luke's Pediatric Endocrinology",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Center Valley, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2021; 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.