NPIMap

Individual provider Active NPI

Samuel James Hertig, PA

  • Medical Physician Assistant
  • Allentown, PA
National Provider Identifier
1275773723
Registry record updated Dec 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
MA060879 Issued in PA
Practice address
1250 S Cedar Crest Blvd Ste 400
Allentown, PA 18103-6224
Phone
(610) 402-6555
Fax
(610) 402-6550
NPI assigned
Feb 24, 2009
Last updated
Dec 15, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 15, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X MA060879 PA Primary

Addresses

Primary practice location

1250 S Cedar Crest Blvd Ste 400
Allentown, PA 18103-6224

Mailing address

426 Cloverleaf Rd
Elizabethtown, PA 17022-9320
Phone (484) 884-4500

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191105000980 PA Practitioner - Physician Assistant 9830460062 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lancaster General Medical GroupGroup PAC ID 0941103683, 590 clinicians

Practice addresses (Care Compare)

1671 Crooked Oak Dr
Lancaster, PA 17601-4269
Phone (717) 569-5331

3045 Marietta Ave
Lancaster, PA 17601-1321
Phone (717) 299-4644

554 N Duke St
LGHP Penn Med Plastic and Cosmetic Surgery
Lancaster, PA 17602-2250
Phone (717) 291-5863

555 N Duke St
Lancaster, PA 17602-2250

555 N Duke St 1St Floor
LGHP Penn Medicine Behavioral Health
Lancaster, PA 17602-2250
Phone (717) 560-3782

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
MA060879PAMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Lehigh Valley Physician Group CurrentSince Jun 1, 2020 Accepting new patients
Lancaster General Medical Group CurrentSince Feb 11, 2022 Accepting new patients
Geisinger Clinic CurrentSince Oct 7, 2019 Accepting new patients
Geisinger Clinic Physician Assistant CurrentSince Oct 7, 2019 Accepting new patients
Lehigh Valley Physician Group CurrentSince Jun 1, 2020 Accepting new patients
Lancaster General Medical Group CurrentSince Feb 11, 2022 Accepting new patients
Lancaster General Medical Group Past Accepting new patients

Locations

1250 S Cedar Crest Blvd
Ste 400
Allentown, PA 18103
Phone (610) 402-3650

100 N Academy Ave
Danville, PA 17822

426 Cloverleaf Rd
Elizabethtown, PA 17022
Phone (717) 299-1301

1671 Crooked Oak Dr
Lancaster, PA 17601
Phone (717) 569-5331

3045 Marietta Ave
Lancaster, PA 17601
Phone (717) 299-4644

554 N Duke St
Lancaster, PA 17602
Phone (717) 291-5863

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

1701 Cornwall Rd
Lebanon, PA 17042
Phone (717) 675-1750

26 N Cedar St
Lititz, PA 17543
Phone (717) 588-1190

1800 Mulberry St
Scranton, PA 18510
Phone (570) 703-7351

Organizations & group practices 10

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 7

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": "1235433600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639526400000",
    "number": "1275773723",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "426 CLOVERLEAF RD",
            "city": "ELIZABETHTOWN",
            "state": "PA",
            "postal_code": "170229320",
            "telephone_number": "484-884-4500",
            "fax_number": "484-664-7659"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1250 S CEDAR CREST BLVD STE 400",
            "city": "ALLENTOWN",
            "state": "PA",
            "postal_code": "181036224",
            "telephone_number": "610-402-6555",
            "fax_number": "610-402-6550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERTIG",
        "first_name": "SAMUEL",
        "middle_name": "JAMES",
        "name_prefix": "Mr.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-02-24",
        "last_updated": "2021-12-15",
        "certification_date": "2021-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "PA",
            "license": "MA060879",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Allentown, PA

Sources for this page

Verify at the official NPI Registry.