NPIMap

Organization Active NPI

St Luke's Physician Group Inc

Doing business as St. Luke's Colon Rectal Surgery Center

  • Colon & Rectal Surgery Physician
  • Bethlehem, PA
National Provider Identifier
1306563838
Registry record updated Oct 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Colon & Rectal Surgery PhysicianTaxonomy code 208C00000X
Legal business name
ST LUKE'S PHYSICIAN GROUP INC
Doing business as
St. Luke's Colon Rectal Surgery Center
Practice address
406 Delaware Ave
Bethlehem, PA 18015-1469
Phone
(610) 866-2600
Fax
(610) 861-7640
NPI assigned
Oct 25, 2022
Last updated
Oct 25, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2022

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

Authorized official

Name
Sue Chiavaroli
Title
Manager
Phone
(484) 526-3569

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Colon & Rectal Surgery PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 208C00000X Primary

Addresses

Primary practice location

406 Delaware Ave
Bethlehem, PA 18015-1469

Mailing address

406 Delaware Ave
Bethlehem, PA 18015-1469
Phone (610) 866-2600

Other names 1

  • St. Luke's Colon Rectal Surgery Center 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

Practitioners & affiliated clinicians

Practitioners 18

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.

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1666656000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1666656000000",
    "number": "1306563838",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "406 DELAWARE AVE",
            "city": "BETHLEHEM",
            "state": "PA",
            "postal_code": "180151469",
            "telephone_number": "610-866-2600",
            "fax_number": "610-861-7640"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "406 DELAWARE AVE",
            "city": "BETHLEHEM",
            "state": "PA",
            "postal_code": "180151469",
            "telephone_number": "610-866-2600",
            "fax_number": "610-861-7640"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST LUKE'S PHYSICIAN GROUP INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-10-25",
        "last_updated": "2022-10-25",
        "certification_date": "2022-10-20",
        "status": "A",
        "authorized_official_last_name": "CHIAVAROLI",
        "authorized_official_first_name": "SUE",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "484-526-3569"
    },
    "taxonomies": [
        {
            "code": "208C00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Colon & Rectal Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "St. Luke's Colon Rectal Surgery 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 Oct 25, 2022; 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.