St Luke'S Physician Group Inc
Organization Active NPI Urogynecology and Reconstructive Pelvic Surgery (Urology) Physician · Lansdale, PA
NPI 1295620607 · NPPES record last updated Jun 9, 2025
Key facts
- NPI
- 1295620607
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Urogynecology and Reconstructive Pelvic Surgery (Urology) Physician 2088F0040X
- Legal business name
- ST LUKE'S PHYSICIAN GROUP INC
- Practice address
- 419 S Broad St Unit 4
Lansdale, PA 19446-3703 - Phone
- (215) 536-3200
- NPI assigned
- Jun 9, 2025
- Organization subpart
- No
Authorized official
- Name
- Sue Chiavaroli
- Title
- Manager
- Phone
- (484) 526-3569
Corporate family (same tax ID) 24
Practitioners 15
-
Roman Bish, M.D.
-
Emily J Briggs, PAC
-
Amber Fitzpatrick, PA-C
-
Alyssa K Lane, PA-C
-
Leah Alexandra Merrick, PA-C
-
Jennifer M. Ou, PA
-
Gianna Rafetto, PA-C
-
Gina Marie Schuett, PA-C
-
Samuel John Slimmer, M.D.
-
Vanessa M. Troyer, PAC
-
Stephanie Lynn Susavage, PA-C
-
Eunice Yang, MD
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in PA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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
- Tax ID family
- Upper Bucks Emergency M
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Urogynecology and Reconstructive Pelvic Surgery (Urology) Physician |
2088F0040X | Yes |
Addresses
Primary practice location
419 S Broad St Unit 4
Lansdale, PA 19446-3703
Mailing address
801 Ostrum St
Bethlehem, PA 18015-1000
Phone (484) 526-4000
Other practice location 1
99 N West End Blvd Ste 103
Quakertown, PA 18951-1272
Phone (215) 536-3200
Other names
- St. Luke's Urogynecology
Other providers in Lansdale, PA
- William H Spellman
- Lois Elaine Spencer McKay
- Spinal Truth Institute LLC
- Samantha R Spinnato
- Rachel Spoonhower
- St Mary Manor
- St Marys Manor
- St. Luke'S Quakertown Hospital
- Lisa Stadulis
- Amanda J. Stahl
All providers in Lansdale, PA · Urogynecology and Reconstructive Pelvic Surgery (Urology) Physician in Pennsylvania
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 9, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.