Individual provider Active NPI

Dylan Lesisko, CRNP

  • Nurse Practitioner
  • Allentown, PA
National Provider Identifier
1295339489
Registry record updated Jun 17, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
NPPA043085 Issued in PA
Practice address
3440 Lehigh St Ste 102
Allentown, PA 18103-7001
Phone
(484) 822-5900
Fax
(866) 672-9882
NPI assigned
Nov 28, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X NPPA043085 PA Primary

Addresses

Primary practice location

3440 Lehigh St Ste 102
Allentown, PA 18103-7001

Mailing address

3440 Lehigh St Ste 102
Allentown, PA 18103-7001
Phone (484) 822-5900

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
I20210318002408 PA Practitioner - Nurse Practitioner 6709293756 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
St Lukes Physician Group IncGroup PAC ID 6709798333, 2,161 clinicians

Practice addresses (Care Compare)

1545 Broadway
Bethlehem, PA 18015-3901
Phone (484) 526-2400

3440 Lehigh St
Allentown, PA 18103-7001

Hospital & facility affiliations

  • St Lukes Hospital Hospital, Bethlehem, PA, CCN 390049

Merit-based Incentive Payment System (MIPS)

Final score
97.13 of 100Reported as apm
Quality
82.27
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
NPPA043085PAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
St Luke'S Physician Group Inc CurrentSince Dec 11, 2020 Accepting new patients
St. Luke'S Physician Group, Inc. Current Accepting new patients
St. Luke'S Physician Group, Inc. CurrentSince Dec 11, 2020 Accepting new patients
St. Luke'S Physician Group, Inc Past Accepting new patients

Locations

3440 Lehigh St
Ste 102
Allentown, PA 18103
Phone (484) 658-5900

1545 Broadway
Bethlehem, PA 18015
Phone (610) 865-6112

619 Dalton St
Emmaus, PA 18049
Phone (610) 965-2574

801 Ostrum St
Fountain Hill, PA 18015
Phone (610) 954-2200

Interoperability endpoints

  • Direct secure messaging: dylan.lesisko@slpg.direct-sluhn.org

Organizations & group practices 4

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 6

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": "1606521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1781654400000",
    "number": "1295339489",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3440 LEHIGH ST STE 102",
            "city": "ALLENTOWN",
            "state": "PA",
            "postal_code": "181037001",
            "telephone_number": "484-822-5900",
            "fax_number": "866-672-9882"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3440 LEHIGH ST STE 102",
            "city": "ALLENTOWN",
            "state": "PA",
            "postal_code": "181037001",
            "telephone_number": "484-822-5900",
            "fax_number": "866-672-9882"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LESISKO",
        "first_name": "DYLAN",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-11-28",
        "last_updated": "2026-06-17",
        "certification_date": "2026-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "PA",
            "license": "NPPA043085",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Allentown, PA

Sources for this page

Verify at the official NPI Registry.