Individual provider Active NPI

Abigail Klitsch, D.O.

  • Pediatrics Physician
  • Bethlehem, PA
National Provider Identifier
1336527308
Registry record updated Sep 13, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
OS019443 Issued in PA
Practice address
325 W Broad St FL 2
Bethlehem, PA 18018-5526
Phone
(484) 626-9222
Fax
(484) 626-9220
NPI assigned
May 11, 2015
Last updated
Sep 13, 2018By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 13, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X OT016541 PA
Pediatrics Physician 208000000X OS019443 PA Primary

Addresses

Primary practice location

325 W Broad St FL 2
Bethlehem, PA 18018-5526

Mailing address

PO Box 783311
Philadelphia, PA 19178-3311
Phone (484) 884-4500

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180928001020 PA Practitioner - Pediatric Medicine 5698088052 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

Practice roles

OrganizationSpecialtyStatusNew patients
Lehigh Valley Physician Group CurrentSince Sep 17, 2018 Accepting new patients
Lehigh Valley Physician Group Pediatrics Current Accepting new patients
Lehigh Valley Physician Group CurrentSince Sep 17, 2018 Accepting new patients
Lehigh Valley Hospital Past Accepting new patients

Locations

1611 Pond Rd
Ste 400
Allentown, PA 18104
Phone (610) 395-4300

2100 Mack Blvd
Fl 4
Allentown, PA 18103

325 W Broad St
Fl 2
Bethlehem, PA 18018
Phone (484) 626-9222

3701 Corriere Rd
Ste 10
Palmer Township, PA 18045
Phone (484) 591-7060

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1431302400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1536796800000",
    "number": "1336527308",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 783311",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191783311",
            "telephone_number": "484-884-4500",
            "fax_number": "484-884-0699"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "325 W BROAD ST FL 2",
            "city": "BETHLEHEM",
            "state": "PA",
            "postal_code": "180185526",
            "telephone_number": "484-626-9222",
            "fax_number": "484-626-9220"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLITSCH",
        "first_name": "ABIGAIL",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-05-11",
        "last_updated": "2018-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "PA",
            "license": "OT016541",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "PA",
            "license": "OS019443",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bethlehem, PA

Sources for this page

Verify at the official NPI Registry.