Individual provider Active NPI

Melissa Dotter

  • Medical Physician Assistant
  • Bethlehem, PA
National Provider Identifier
1275902819
Registry record updated Jan 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
MA057798 Issued in PA
Practice address
2545 Schoenersville Rd
Bethlehem, PA 18017-7300
Phone
(484) 884-2200
NPI assigned
Sep 24, 2015
Last updated
Jan 12, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 12, 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 MA057798 PA Primary

Addresses

Primary practice location

2545 Schoenersville Rd
Bethlehem, PA 18017-7300

Mailing address

2100 Mack Blvd FL 4
Allentown, PA 18103-5622

Other names 1

  • Melissa Clark Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151016002131 PA Practitioner - Physician Assistant 3870802655 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lehigh Valley Physician GroupGroup PAC ID 3072425123, 2,512 clinicians

Practice addresses (Care Compare)

1210 S Cedar Crest Blvd
Allentown, PA 18103-6235
Phone (610) 402-3888

2545 Schoenersville Rd
Bethlehem, PA 18017-7300

5649 Wynnewood Dr
Laurys Station, PA 18059-1124

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MA057798PAMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Lehigh Valley Physician Group CurrentSince Oct 23, 2015 Accepting new patients
Lehigh Valley Physician Group CurrentSince Oct 23, 2015 Accepting new patients

Locations

2100 Mack Blvd
Fl 4
Allentown, PA 18103

2545 Schoenersville Rd
Bethlehem, PA 18017
Phone (484) 884-2888

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

Organizations & group practices 3

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 5

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": "1443052800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610409600000",
    "number": "1275902819",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 MACK BLVD FL 4",
            "city": "ALLENTOWN",
            "state": "PA",
            "postal_code": "181035622"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2545 SCHOENERSVILLE RD",
            "city": "BETHLEHEM",
            "state": "PA",
            "postal_code": "180177300",
            "telephone_number": "484-884-2200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOTTER",
        "first_name": "MELISSA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-09-24",
        "last_updated": "2021-01-12",
        "certification_date": "2021-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "PA",
            "license": "MA057798",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MELISSA",
            "last_name": "CLARK",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Bethlehem, PA

Sources for this page

Verify at the official NPI Registry.