Individual provider Active NPI

Elaine Donoghue, MD

  • Pediatrics Physician
  • Allentown, PA
National Provider Identifier
1194794529
Registry record updated Jul 25, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
MD438986 Issued in PA
Practice address
17TH and Chew Streets
Allentown, PA 18102-3698
Phone
(610) 969-4300
NPI assigned
Mar 17, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 25, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 25MA06070400 NJ
Pediatrics Physician 208000000X MD438986 PA Primary

Addresses

Primary practice location

17TH and Chew Streets
Allentown, PA 18102-3698

Mailing address

PO Box 783311
Philadelphia, PA 19178-3311
Phone (484) 884-4500

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170505000884 PA Practitioner - Pediatric Medicine 1557393121 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
25MA06070400NJMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lehigh Valley Physician Group Pediatrics Current Accepting new patients
Lehigh Valley Physician Group CurrentSince Dec 6, 2017 Accepting new patients
Lehigh Valley Physician Group CurrentSince Dec 6, 2017 Accepting new patients
Hackensack Meridian Health Medical Group - Complex Care PC Pediatrics PastSince Apr 6, 2021 Accepting new patients

Locations

2100 Mack Blvd
Fl 4
Allentown, PA 18103

564 W Broad St
Ste 3
Hazleton, PA 18201
Phone (570) 501-6400

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": "1142553600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1469404800000",
    "number": "1194794529",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 783311",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191783311",
            "telephone_number": "484-884-4500",
            "fax_number": "484-884-0699"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17TH AND CHEW STREETS",
            "city": "ALLENTOWN",
            "state": "PA",
            "postal_code": "181023698",
            "telephone_number": "610-969-4300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DONOGHUE",
        "first_name": "ELAINE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-17",
        "last_updated": "2016-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NJ",
            "license": "25MA06070400",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "PA",
            "license": "MD438986",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Allentown, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2016; 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.