St. Luke'S Physician Group, Inc.
Organization Active NPI Surgery Physician · Quakertown, PA
NPI 1245321199 · NPPES record last updated Jun 13, 2019
Key facts
- NPI
- 1245321199
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Surgery Physician 208600000X
- Legal business name
- ST. LUKE'S PHYSICIAN GROUP, INC.
- Practice address
- 1021 Park Ave Ste 100B
Quakertown, PA 18951-0130 - Phone
- (215) 538-4852
- Fax
- (215) 529-4685
- NPI assigned
- Sep 27, 2006
- Organization subpart
- No
Authorized official
- Name
- Dean W. Evans
- Title
- President
- Phone
- (484) 526-4991
Practitioners 13
-
Shane Barre, DO
-
Jeffrey Scott Berger, D.O.
-
Sheri L Floyd, CRNA
-
Bethanie M Greco, CRNP
-
Angela C Hartman, CRNA
-
Debra A Kramer, CRNP
-
Tara Michelle Laforge, PA-C
-
Stefanie L. Ott, CRNA
-
Benjamin Rohrer, M.D.
-
Evan T Rubin, CRNA
-
Morgan Craft, PA-C
-
Marlon Pastrana, M.D.
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
Locations
240 Cetronia Rd
Ste 200
Allentown, PA 18104
Phone (484) 426-2670
701 Ostrum St
Ste 603503
Fountain Hill, PA 18015
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician |
208600000X | Yes |
Addresses
Primary practice location
1021 Park Ave Ste 100B
Quakertown, PA 18951-0130
Mailing address
1021 Park Ave Ste 100B
Quakertown, PA 18951-0130
Phone (215) 538-4852
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1007307530102 | Medicaid | PA |
Other names
- St. Luke's General Surgery Quakertown
Other providers in Quakertown, PA
- 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.
- 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 Quakertown, PA · Surgery 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 Jun 13, 2019. 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.