NPIMap

Organization Active NPI

St. Luke's Physician Group, Inc

  • Family Medicine Physician
  • Nazareth, PA
National Provider Identifier
1215230420
Registry record updated Jan 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
ST. LUKE'S PHYSICIAN GROUP, INC
Practice address
305 W North St
Nazareth, PA 18064-1308
Phone
(610) 759-6145
Fax
(866) 521-0517
NPI assigned
Dec 9, 2010
Last updated
Jan 17, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 17, 2018

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

Authorized official

Name
Dean W Evans
Title
President
Phone
(610) 954-4911

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X PA Primary

Addresses

Primary practice location

305 W North St
Nazareth, PA 18064-1308

Mailing address

801 Ostrum St
Bethlehem, PA 18015-1000
Phone (610) 759-6145

Other practice location 1

25 S Broad St
Nazareth, PA 18064-2255
Phone (610) 759-6145

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
Tax ID family
St Lukes Surgical Assoc165 organizations share this tax ID, including this one

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

5325 Northgate Dr
Ste 201
Bethlehem, PA 18017
Phone (610) 625-4400

770 State Rd
Lehighton, PA 18235
Phone (484) 613-4002

Practitioners & affiliated clinicians

Practitioners 18

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.

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1291852800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1516147200000",
    "number": "1215230420",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 OSTRUM ST",
            "city": "BETHLEHEM",
            "state": "PA",
            "postal_code": "180151000",
            "telephone_number": "610-759-6145",
            "fax_number": "866-521-0517"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "305 W NORTH ST",
            "city": "NAZARETH",
            "state": "PA",
            "postal_code": "180641308",
            "telephone_number": "610-759-6145",
            "fax_number": "866-521-0517"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "25 S Broad St",
            "address_purpose": "LOCATION",
            "city": "Nazareth",
            "state": "PA",
            "postal_code": "180642255",
            "country_code": "US",
            "telephone_number": "610-759-6145",
            "fax_number": "610-759-4590",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "ST. LUKE'S PHYSICIAN GROUP, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-12-09",
        "last_updated": "2018-01-17",
        "status": "A",
        "authorized_official_last_name": "EVANS",
        "authorized_official_first_name": "DEAN",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "610-954-4911"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Nazareth, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2018; 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.