St. Luke's Physician Group, Inc.

Primary specialty

Critical Care Medicine (Internal Medicine) PhysicianTaxonomy code 207RC0200X

Legal business name

ST. LUKE'S PHYSICIAN GROUP, INC.

Doing business as

St. Luke's Critical Care Associates

Practice address

801 Ostrum St
Bethlehem, PA 18015-1000

Phone

(484) 526-2222

Fax

(866) 829-9836

NPI assigned

Jul 19, 2006

Last updated

Aug 25, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dean W Evans

Title

President

Phone

(484) 526-4991

Specialties & licenses 5

Addresses

Other identifiers 2

Other names 1

• St. Luke's Critical Care Associates Doing business as

Medicare fee-for-service enrollment

Enrolled in PA

Enrollment records 1

Locations

Practitioners 38

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.

• Natalie Corin Akers, MD

  • Emergency Medicine Physician
  • Bethlehem, PA
  • NPI 1548825250
  NPD
• Michael Wagih Awadallah, DDS, MD

  • Oral and Maxillofacial Surgery (Dentist)
  • Bethlehem, PA
  • NPI 1205273117
  NPD
• Mary Donna Mananghaya Cruz, M.D.

  • Advanced Heart Failure and Transplant Cardiology Physician
  • Bethlehem, PA
  • NPI 1922305952
  NPD
• Kendra Olivia Davis, DO

  • Surgical Critical Care Physician
  • Bethlehem, PA
  • NPI 1174864144
  NPD
• Albert G Driver Jr., MD

  • Pulmonary Disease Physician
  • Sellersville, PA
  • NPI 1811973803
  NPD
• Nathaniel Ian Estock

  • Physician Assistant
  • Fountain Hill, PA
  • NPI 1215829932
  NPD
• Julie Ann Farrell, RD, PA-C

  • Physician Assistant
  • Stroudsburg, PA
  • NPI 1144536533
  NPD
• Olufunmilayo Esther Folaranmi, MD

  • Internal Medicine Physician
  • Philadelphia, PA
  • NPI 1679132419
  NPD
• Shannon M Foster, MD

  • Surgery Physician
  • Hershey, PA
  • NPI 1699755496
  NPD
• William Goodland

  • Physician Assistant
  • Lehighton, PA
  • NPI 1255976395
  NPD
• Daniel S Hensley, PA-C, LAT, ATC

  • Physician Assistant
  • Colmar, PA
  • NPI 1700302858

  Single Specialty

  NPD
• Decosy Hercules, D.O.

  • Sports Medicine (Family Medicine) Physician
  • Bethlehem, PA
  • NPI 1356778542
  NPD

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

{
    "created_epoch": "1153267200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1629849600000",
    "number": "1326067430",
    "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": "484-526-2200",
            "fax_number": "866-829-9836"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 OSTRUM ST",
            "city": "BETHLEHEM",
            "state": "PA",
            "postal_code": "180151000",
            "telephone_number": "484-526-2222",
            "fax_number": "866-829-9836"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1872 St Lukes Blvd",
            "address_purpose": "LOCATION",
            "city": "Easton",
            "state": "PA",
            "postal_code": "180455669",
            "country_code": "US",
            "telephone_number": "484-526-2200",
            "fax_number": "866-829-9836",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "100 St Lukes Ln",
            "address_purpose": "LOCATION",
            "city": "Stroudsburg",
            "state": "PA",
            "postal_code": "183606217",
            "country_code": "US",
            "telephone_number": "484-526-2200",
            "fax_number": "866-829-9836",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "360 W Ruddle St",
            "address_purpose": "LOCATION",
            "city": "Coaldale",
            "state": "PA",
            "postal_code": "182181027",
            "country_code": "US",
            "telephone_number": "484-526-2200",
            "fax_number": "866-829-9836",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1736 Hamilton St",
            "address_purpose": "LOCATION",
            "city": "Allentown",
            "state": "PA",
            "postal_code": "181045656",
            "country_code": "US",
            "telephone_number": "484-526-2200",
            "fax_number": "866-829-9836",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "100 St Lukes Ln",
            "address_purpose": "LOCATION",
            "city": "Stroudsburg",
            "state": "PA",
            "postal_code": "183606217",
            "country_code": "US",
            "telephone_number": "484-526-2200",
            "fax_number": "866-829-9836",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1872 St Lukes Blvd",
            "address_purpose": "LOCATION",
            "city": "Easton",
            "state": "PA",
            "postal_code": "180455669",
            "country_code": "US",
            "telephone_number": "484-526-2200",
            "fax_number": "866-829-9836",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "801 Ostrum St",
            "address_purpose": "LOCATION",
            "city": "Bethlehem",
            "state": "PA",
            "postal_code": "18015",
            "country_code": "US",
            "telephone_number": "484-526-2222",
            "fax_number": "484-526-2398",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "360 W Ruddle St",
            "address_purpose": "LOCATION",
            "city": "Coaldale",
            "state": "PA",
            "postal_code": "182181027",
            "country_code": "US",
            "telephone_number": "484-526-2200",
            "fax_number": "866-829-9836",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1736 Hamilton St",
            "address_purpose": "LOCATION",
            "city": "Allentown",
            "state": "PA",
            "postal_code": "181045656",
            "country_code": "US",
            "telephone_number": "484-526-2200",
            "fax_number": "866-829-9836",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "ST. LUKE'S PHYSICIAN GROUP, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-19",
        "last_updated": "2021-08-25",
        "certification_date": "2021-08-25",
        "status": "A",
        "authorized_official_last_name": "EVANS",
        "authorized_official_first_name": "DEAN",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "484-526-4991"
    },
    "taxonomies": [
        {
            "code": "207LC0200X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Critical Care Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2086S0102X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgical Critical Care",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "034134",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1007307530297",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "St. Luke's Critical Care Associates",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "St. Luke's Critical Care Associates",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• St. Luke's Physician Group, Inc.
• St. Luke's Physician Group, Inc.
• St. Luke's Physician Group, Inc. (St. Luke's Cardiovascular Surgical Associates)
• St. Luke's Physician Group, Inc. (Bethlehem Neonatal Associates)
• St. Luke's Physician Group, Inc.
• St. Luke's Physician Group, Inc.
• St. Luke's Physician Group, Inc. (St. Luke's Pediatric Pulmonology)
• St. Luke's Physician Group, Inc.
• St. Luke's Physician Group, Inc. (St. Luke's Cardiac Testing Center)
• St. Luke's Physician Group, Inc. (St. Luke's Plastic & Reconstructive Surgery)

• Critical Care Medicine (Internal Medicine) Physician in Bethlehem, PA
• Providers in Bethlehem, PA by specialty
• Critical Care Medicine (Internal Medicine) Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2021; 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.