St. Luke'S Physician Group, Inc.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

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

Organization subpart

No

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

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in PA

Enrollment records 1

Practitioners 10

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Marie Jamie Fluke, PA-C

  • Physician Assistant
  • Tamaqua, PA
  • NPI 1326371865
  NPD
• Amy L. Houm, M.D.

  • Pediatrics Physician
  • Palmerton, PA
  • NPI 1255313292
  NPD
• Craig J Krause, DO

  • Family Medicine Physician
  • Tamaqua, PA
  • NPI 1992805519
  NPD
• Rebekah Kuzio, CRNP

  • Nurse Practitioner
  • Ashland, PA
  • NPI 1851181135
  NPD
• David F McPherson, MD

  • Family Medicine Physician
  • Tamaqua, PA
  • NPI 1467191221
  NPD
• Kyle Matthew Mummey, PA-C

  • Physician Assistant
  • Sugarloaf, PA
  • NPI 1831233881
  NPD
• Victor Martin Otero, M.D.

  • Family Medicine Physician
  • Allentown, PA
  • NPI 1730129099
  NPD
• Emily Nicole Pun, PA-C

  • Physician Assistant
  • Orwigsburg, PA
  • NPI 1831676618
  NPD
• Stephanie M Ziegler, CRNP

  • Adult Health Nurse Practitioner
  • Quakertown, PA
  • NPI 1063091270
  NPD
• Richard Alcide Gilbert, D.O.

  • Family Medicine Physician
  • Charlotte Hall, MD
  • NPI 1588762272
  NPD

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": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1007307530232",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ashley Lyn Smolinsky, PT
• Spaeth, Katz, Myers PC
• St. Luke'S Miners Memorial Home Care
• St. Luke'S Physician Group Inc.
• St. Luke'S Physician Group, Inc.
• St. Luke'S Physician Group, Inc.
• Kelly Jo Stroede, CRNP
• Stephanie Dawn Strouse, OTR/L
• Sair Ahmad Tabraiz
• Tamaqaa Drug Store Inc

• Family Medicine Physician in Tamaqua, PA
• Providers in Tamaqua, PA by specialty
• Family Medicine Physician in Pennsylvania

• 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.

Verify at the official NPI Registry.