NPIMap

Individual provider Active NPI

C Gerard Petersen, MD

  • Pulmonary Disease Physician
  • Allentown, PA
National Provider Identifier
1285684183
Registry record updated Mar 22, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
MD073487L Issued in PA
Practice address
1250 S Cedar Crest Blvd
Suite 205
Allentown, PA 18103-6224
Phone
(610) 439-8856
NPI assigned
May 11, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 22, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pulmonary Disease Physician 207RP1001X MD073487L PA Primary

Addresses

Primary practice location

1250 S Cedar Crest Blvd
Suite 205
Allentown, PA 18103-6224

Mailing address

PO Box 783311
Philadelphia, PA 19178-3311
Phone (484) 884-4500

Other identifiers 1

IdentifierTypeStateIssuer
50059765OtherPACAPITAL BLUE CROSS

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
I20040809001163 PA Practitioner - Pulmonary DiseasePractitioner - Critical Care (Intensivists) 1557333788 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pulmonary DiseaseAlso: Critical Care (Intensivists)
Education
Tufts University School of Medicine, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Lehigh Valley Physician Group 2,512 clinicians

Practice addresses (Care Compare)

1250 S Cedar Crest Blvd
200 LVPG Infectious Disease
Allentown, PA 18103-6253
Phone (610) 402-8430

Hospital & facility affiliations

  • Lehigh Valley Hospital Hospital, Allentown, PA, CCN 390133
  • Schuylkill Medical Center - South Jackson Street Hospital, Pottsville, PA, CCN 390030
  • Lehigh Valley Hospital - Hazleton Hospital, Hazleton, PA, CCN 390185
  • Lehigh Valley Hospital - Pocono Hospital, East Stroudsburg, PA, CCN 390201

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Lehigh Valley Physician Group Current Accepting new patients
Schuylkill Health System Medical Group, Inc. CurrentSince Sep 18, 2017 Accepting new patients
Schuylkill Health System Medical Group, Inc. Pulmonary Disease CurrentSince Sep 18, 2017 Accepting new patients
Lehigh Valley Physician Group CurrentSince Jul 1, 2006 Accepting new patients
Lehigh Valley Physician Group CurrentSince Dec 1, 2019 Accepting new patients
Hazleton Professional Services Current Accepting new patients
Lehigh Valley Physician Group CurrentSince Jul 1, 2006 Accepting new patients
Pulmonary Associates PC Pulmonary Disease Past Accepting new patients

Locations

1250 S Cedar Crest Blvd
Ste 200
Allentown, PA 18103
Phone (610) 402-3701

1901 Hamilton St
Ste 100B
Allentown, PA 18104
Phone (610) 973-1410

1250 S Cedar Crest Blvd
Ste 205
Allentown, PA 18103
Phone (610) 402-9116

1770 Bathgate Rd
Ste 401
Bethlehem, PA 18017
Phone (484) 884-8840

5325 Northgate Dr
Ste 209
Bethlehem, PA 18017
Phone (610) 625-8898

50 Moisey Dr
Ste 109
Hazle Township, PA 18202
Phone (570) 501-6460

1000 Alliance Dr
#10
Hazleton, PA 18202
Phone (570) 501-6450

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

700 E Norwegian St
Pottsville, PA 17901
Phone (570) 621-4000

700 Schuylkill Manor Rd
Ste 3
Pottsville, PA 17901
Phone (570) 621-4440

420 S Jackson St
Pottsville, PA 17901
Phone (570) 621-5000

Interoperability endpoints

  • Direct secure messaging: cpetersen11490@direct2.lvhn.org

Organizations & group practices 12

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

Hospital & facility affiliations 9

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": "1147305600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1458604800000",
    "number": "1285684183",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 783311",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191783311",
            "telephone_number": "484-884-4500",
            "fax_number": "484-884-0699"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1250 S CEDAR CREST BLVD",
            "address_2": "SUITE 205",
            "city": "ALLENTOWN",
            "state": "PA",
            "postal_code": "181036224",
            "telephone_number": "610-439-8856"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSEN",
        "first_name": "C",
        "middle_name": "GERARD",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-11",
        "last_updated": "2016-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "PA",
            "license": "MD073487L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAPITAL BLUE CROSS",
            "identifier": "50059765",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Allentown, PA

Sources for this page

Verify at the official NPI Registry.