NPIMap

Organization Active NPI

St. Luke's Physician Group, Inc.

Doing business as St. Luke's Nephrology Associates of Carbon County

  • Nephrology Physician
  • Palmerton, PA
National Provider Identifier
1285298737
Registry record updated Apr 30, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
Legal business name
ST. LUKE'S PHYSICIAN GROUP, INC.
Doing business as
St. Luke's Nephrology Associates of Carbon County
Practice address
218A Delaware Ave
Palmerton, PA 18071-1813
Phone
(610) 826-6353
Fax
(610) 826-6359
NPI assigned
Apr 30, 2019
Last updated
Apr 30, 2019By the provider in NPPES
Organization subpart
Yes
Parent organization
ST. LUKE'S PHYSICIAN GROUP, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 30, 2019

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

Authorized official

Name
Dean Evans
Title
President
Phone
(484) 526-4999

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X NU Primary

Addresses

Primary practice location

218A Delaware Ave
Palmerton, PA 18071-1813

Mailing address

218A Delaware Ave
Palmerton, PA 18071-1813
Phone (610) 826-6353

Other names 1

  • St. Luke's Nephrology Associates of Carbon County Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
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 Directory
Part of
St Lukes Surgical Assoc

Practitioners & affiliated clinicians

Practitioners 9

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1556582400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1556582400000",
    "number": "1285298737",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "218A DELAWARE AVE",
            "city": "PALMERTON",
            "state": "PA",
            "postal_code": "180711813",
            "telephone_number": "610-826-6353",
            "fax_number": "610-826-6359"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "218A DELAWARE AVE",
            "city": "PALMERTON",
            "state": "PA",
            "postal_code": "180711813",
            "telephone_number": "610-826-6353",
            "fax_number": "610-826-6359"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST. LUKE'S PHYSICIAN GROUP, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ST. LUKE'S PHYSICIAN GROUP, INC.",
        "enumeration_date": "2019-04-30",
        "last_updated": "2019-04-30",
        "status": "A",
        "authorized_official_last_name": "EVANS",
        "authorized_official_first_name": "DEAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "484-526-4999"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "St. Luke's Nephrology Associates of Carbon County",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Palmerton, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2019; 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.