Individual provider Active NPI

Kevan Iffrig

  • Urology Physician
  • Bethlehem, PA
National Provider Identifier
1215347471
Registry record updated Nov 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
MD469271 Issued in PA
Practice address
2649 Schoenersville Rd Ste 101
Bethlehem, PA 18017-7317
Phone
(484) 884-3600
NPI assigned
Apr 28, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 20, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X 30845 NE
Urology Physician 208800000X MD469271 PA Primary

Addresses

Primary practice location

2649 Schoenersville Rd Ste 101
Bethlehem, PA 18017-7317

Mailing address

Evans Army Community Hospital
1650 Cochrane Cir B7500
Ft Carson, CO 80913

Other practice location 1

Evans Army Community Hospital
1650 Cochrane Cir B7500
Ft Carson, CO 80913
Phone (719) 526-7115

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, CO2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20200218000326 PA Practitioner - Urology 9032546890 Reassigns benefits to 5 organizations
I20200715001720 CO Practitioner - Urology 9032546890 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
Temple University School of Medicine, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Lehigh Valley Physician GroupGroup PAC ID 3072425123, 2,512 clinicians

Practice addresses (Care Compare)

2649 Schoenersville Rd
Suite 101
Bethlehem, PA 18017-7317
Phone (484) 884-3600

Hospital & facility affiliations

  • Lehigh Valley Home Care Home health agency, Allentown, PA, CCN 397023
  • Lehigh Valley Hospital Hospital, Allentown, PA, CCN 390133
  • Lehigh Valley Hospital - Hazleton Hospital, Hazleton, PA, CCN 390185
  • Schuylkill Medical Center - South Jackson Street Hospital, Pottsville, PA, CCN 390030
  • Lehigh Valley Hospital - Pocono Hospital, East Stroudsburg, PA, CCN 390201
  • Lehigh Valley Hospital - Macungie Hospital, Macungie, PA, CCN 390430

Procedures performed for Medicare patients

ProcedureNumber of procedures
Prostate resection11

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD469271PAMDUrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hazleton Professional Services CurrentSince Aug 7, 2023 Accepting new patients
Poudre Valley Medical Group, LLC CurrentSince Jun 18, 2021 Accepting new patients
DLP Conemaugh Physician Practices LLC CurrentSince Feb 17, 2020 Accepting new patients
Lehigh Valley Physician Group CurrentSince Aug 7, 2023 Accepting new patients
Poudre Valley Medical Group, LLC Urology CurrentSince Jun 18, 2021 Accepting new patients
DLP Conemaugh Physician Practices LLC CurrentSince Feb 17, 2020 Accepting new patients
Lehigh Valley Physician Group Current Accepting new patients
Family Care Centers Inc CurrentSince May 1, 2023 Accepting new patients
Lehigh Valley Physician Group CurrentSince Jun 26, 2023 Accepting new patients
DLP Conemaugh Physician Practices LLC Current Accepting new patients
Family Care Centers Inc. Current Accepting new patients
G. U., Inc. Urology CurrentSince Feb 4, 2024 Accepting new patients
Lehigh Valley Physician Group CurrentSince Jun 26, 2023 Accepting new patients
Windber Hospital, Inc. Past Accepting new patients
Lehigh Valley Hospital Past Accepting new patients

Locations

4404 Barranca Ln
Castle Rock, CO 80104
Phone (720) 733-5260

175 S Union Blvd
Ste 315
Colorado Springs, CO 80910
Phone (719) 365-3700

2695 Rocky Mountain Ave
Ste 150
Loveland, CO 80538
Phone (970) 624-2412

1619 N Greenwood St
Ste 106
Pueblo, CO 81003
Phone (719) 595-7760

4100 Jerry Murphy Rd
Pueblo, CO 81001
Phone (719) 544-7070

2100 Mack Blvd
Fl 4
Allentown, PA 18103

2649 Schoenersville Rd
Ste 101
Bethlehem, PA 18017
Phone (484) 884-3600

422 Normal St
East Stroudsburg, PA 18301
Phone (570) 424-2100

500 Plaza Ct
East Stroudsburg, PA 18301
Phone (570) 426-2330

50 Moisey Dr
Ste 210
Hazle Township, PA 18202
Phone (570) 501-6380

1000 Alliance Dr
#10
Hazleton, PA 18202
Phone (570) 501-6450

1111 Franklin St
Ste 410
Johnstown, PA 15905
Phone (814) 536-7851

1111 Franklin St
Ste 180
Johnstown, PA 15905
Phone (814) 534-3740

1086 Franklin St
Johnstown, PA 15905
Phone (610) 250-4540

911 Ligonier St
Ste 104
Latrobe, PA 15650
Phone (724) 539-9736

5649 Wynnewood Dr
Ste 104
Laurys Station, PA 18059
Phone (610) 262-6641

2226 Blakeslee Boulevard Dr E
#200
Lehighton, PA 18235
Phone (484) 884-1007

Organizations & group practices 16

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.

View all 16

Hospital & facility affiliations 12

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1398643200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700438400000",
    "number": "1215347471",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "EVANS ARMY COMMUNITY HOSPITAL",
            "address_2": "1650 COCHRANE CIR B7500",
            "city": "FT CARSON",
            "state": "CO",
            "postal_code": "80913"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2649 SCHOENERSVILLE RD STE 101",
            "city": "BETHLEHEM",
            "state": "PA",
            "postal_code": "180177317",
            "telephone_number": "484-884-3600"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "EVANS ARMY COMMUNITY HOSPITAL",
            "address_2": "1650 COCHRANE CIR B7500",
            "address_purpose": "LOCATION",
            "city": "FT CARSON",
            "state": "CO",
            "postal_code": "80913",
            "country_code": "US",
            "telephone_number": "719-526-7115",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "IFFRIG",
        "first_name": "KEVAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-04-28",
        "last_updated": "2023-11-20",
        "certification_date": "2023-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "NE",
            "license": "30845",
            "primary": false
        },
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "PA",
            "license": "MD469271",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bethlehem, PA

Sources for this page

Verify at the official NPI Registry.