NPIMap

Organization Active NPI

St. Luke's Hospital

Doing business as St. Luke's Southside Medical Center

  • Internal Medicine Physician
  • Bethlehem, PA
National Provider Identifier
1285728386
Registry record updated Apr 23, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
ST. LUKE'S HOSPITAL
Doing business as
St. Luke's Southside Medical Center
Practice address
511 E 3Rd St
Suite 200
Bethlehem, PA 18015-2072
Phone
(484) 526-4700
NPI assigned
Oct 3, 2006
Last updated
Apr 23, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 23, 2012

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

Authorized official

Name
Thomas Lichtenwalner
Title
Vice President
Phone
(484) 526-3301

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X PA Primary

Addresses

Primary practice location

511 E 3Rd St
Suite 200
Bethlehem, PA 18015-2072

Mailing address

801 Ostrum St
Bethlehem, PA 18015-1000
Phone (610) 954-6048

Other names 1

  • St. Luke's Southside Medical Center Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031106000233 PA Part B Supplier - Clinic/Group Practice 0648189688 Receives reassigned benefits from 59 practitioners
15 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Quakertown, PA; Easton, PA; Bethlehem, PA; Allentown, PA

Other NPIs on the same Medicare enrollment 15

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 15

National Provider Directory

National Provider Directory

Locations

511 E 3rd St
Ste 200
Bethlehem, PA 18015
Phone (484) 526-4700

Practitioners & affiliated clinicians

Practitioners 8

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": "1159833600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1335139200000",
    "number": "1285728386",
    "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": "610-954-6048",
            "fax_number": "610-954-3189"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "511 E 3RD ST",
            "address_2": "SUITE 200",
            "city": "BETHLEHEM",
            "state": "PA",
            "postal_code": "180152072",
            "telephone_number": "484-526-4700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST. LUKE'S HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-03",
        "last_updated": "2012-04-23",
        "status": "A",
        "authorized_official_last_name": "LICHTENWALNER",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "484-526-3301"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "St. Luke's Southside Medical Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bethlehem, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2012; 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.