Active NPI
St. Luke's Physician Group, Inc.
- Family Medicine Physician
- Tamaqua, PA
National Provider Identifier
1255438529
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- Legal business name
- ST. LUKE'S PHYSICIAN GROUP, INC.
- Practice address
- 143 N Railroad St
Tamaqua, PA 18252-1330 - Phone
- (484) 526-4000
- NPI assigned
- Sep 20, 2006
- Last updated
- Jun 24, 2021
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Susan Chiavaroli
- Title
- Cvo Supervisor
- Phone
- (484) 526-3569
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | PA | Primary |
Addresses
Primary practice location
143 N Railroad St
Tamaqua, PA 18252-1330
Mailing address
801 Ostrum St
Bethlehem, PA 18015-1000
Phone (570) 645-1540
Other practice location 1
120 Pine St Ste B
Tamaqua, PA 18252-1409
Phone (570) 645-1540
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in PA
Enrollment records 1
| 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
National Provider DirectoryPractitioners & affiliated clinicians
Practitioners 10
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.
-
- Physician Assistant
- Tamaqua, PA
- NPI 1326371865
-
- Pediatrics Physician
- Palmerton, PA
- NPI 1255313292
-
- Family Medicine Physician
- Tamaqua, PA
- NPI 1992805519
-
- Nurse Practitioner
- Ashland, PA
- NPI 1851181135
-
- Family Medicine Physician
- Tamaqua, PA
- NPI 1467191221
-
- Physician Assistant
- Sugarloaf, PA
- NPI 1831233881
-
- Family Medicine Physician
- Allentown, PA
- NPI 1730129099
-
- Physician Assistant
- Orwigsburg, PA
- NPI 1831676618
-
- Adult Health Nurse Practitioner
- Quakertown, PA
- NPI 1063091270
-
- Family Medicine Physician
- Charlotte Hall, MD
- NPI 1588762272
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158710400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1624492800000",
"number": "1255438529",
"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": "570-645-1540"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "143 N RAILROAD ST",
"city": "TAMAQUA",
"state": "PA",
"postal_code": "182521330",
"telephone_number": "484-526-4000"
}
],
"practiceLocations": [
{
"address_1": "120 Pine St Ste B",
"address_purpose": "LOCATION",
"city": "Tamaqua",
"state": "PA",
"postal_code": "182521409",
"country_code": "US",
"telephone_number": "570-645-1540",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"organization_name": "ST. LUKE'S PHYSICIAN GROUP, INC.",
"organizational_subpart": "NO",
"enumeration_date": "2006-09-20",
"last_updated": "2021-06-24",
"certification_date": "2021-06-24",
"status": "A",
"authorized_official_last_name": "CHIAVAROLI",
"authorized_official_first_name": "SUSAN",
"authorized_official_title_or_position": "CVO SUPERVISOR",
"authorized_official_telephone_number": "484-526-3569"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Family Medicine",
"state": "PA",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Tamaqua, PA
- Ashley Lyn Smolinsky, PT
- Spaeth, Katz, Myers PC
- St. Luke's Miners Memorial Home Care
- St. Luke's Physician Group Inc. (St. Luke's ENT Associates)
- St. Luke's Physician Group, Inc. (St. Luke's Internal Medicine at Tamaqua)
- St. Luke's Physician Group, Inc. (St. Luke's Hometown Family Medicine)
- Kelly Jo Stroede, CRNP
- Stephanie Dawn Strouse, OTR/L
- Sair Ahmad Tabraiz
- Tamaqaa Drug Store Inc
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 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.