NPIMap

Individual provider Active NPI

Decosy Hercules, D.O.

  • Sports Medicine (Family Medicine) Physician
  • Bethlehem, PA
National Provider Identifier
1356778542
Registry record updated Oct 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Family Medicine) PhysicianTaxonomy code 207QS0010X
License
OS018633 Issued in PA
Practice address
801 Ostrum St Ste 2
Bethlehem, PA 18015-1000
Phone
(484) 526-1735
Fax
(484) 526-2429
NPI assigned
Oct 2, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 12, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Family Medicine) Physician 207QS0010X OS018633 PA Primary

Addresses

Primary practice location

801 Ostrum St Ste 2
Bethlehem, PA 18015-1000

Mailing address

801 Ostrum St Ste 2
Bethlehem, PA 18015-1000
Phone (484) 526-1735

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171129000168 PA Practitioner - Sports MedicinePractitioner - Family Practice 3173880127 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Sports Medicine
Education
Rowan University School of Osteopathic Medicine, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Lukes Physician Group IncGroup PAC ID 6709798333, 2,161 clinicians

Practice addresses (Care Compare)

801 Ostrm St
Bethlehem, PA 18015-1000
Phone (610) 954-4000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
OS018633PAMDSports Medicine (Family Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Greater Philadelphia Health Action, Inc. CurrentSince Oct 4, 2017 Accepting new patients
Greater Philadelphia Health Action Inc. CurrentSince Oct 4, 2017 Accepting new patients
St Luke's Physician Group Inc CurrentSince Dec 1, 2017 Accepting new patients
Greater Philadelphia Health Action Inc. Current Accepting new patients
Gslpg, Inc CurrentSince Nov 4, 2019 Accepting new patients
St. Luke's Physician Group, Inc. CurrentSince Dec 1, 2017 Accepting new patients
St. Luke's Physician Group, Inc. Current Accepting new patients
St. Luke's Physician Group, Inc Past Accepting new patients

Locations

111 Route 715
Ste 104
Brodheadsvlle, PA 18322
Phone (272) 212-0435

701 Ostrum St
Ste 602
Fountain Hill, PA 18015
Phone (610) 807-9400

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

801 Ostrum St
Ste 2
Fountain Hill, PA 18015
Phone (610) 954-1735

575 S 9th St
Ste 5
Lehighton, PA 18235

100 Paramount Blvd
Orwigsburg, PA 17961
Phone (272) 639-1000

4510 Frankford Ave
Philadelphia, PA 19124
Phone (215) 744-1302

1999 W Hunting Park Ave
Philadelphia, PA 19140
Phone (215) 228-9300

432 N 6th St
Philadelphia, PA 19123
Phone (215) 627-8000

5501 Woodland Ave
Philadelphia, PA 19143
Phone (215) 724-4700

200 St Lukes Ln
Ste 200
Stroudsburg, PA 18360
Phone (908) 208-1838

Interoperability endpoints

  • Direct secure messaging: decosy.hercules@slpg.direct-sluhn.org

Organizations & group practices 8

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 10

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": "1380672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697068800000",
    "number": "1356778542",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 OSTRUM ST STE 2",
            "city": "BETHLEHEM",
            "state": "PA",
            "postal_code": "180151000",
            "telephone_number": "484-526-1735",
            "fax_number": "484-526-2429"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 OSTRUM ST STE 2",
            "city": "BETHLEHEM",
            "state": "PA",
            "postal_code": "180151000",
            "telephone_number": "484-526-1735",
            "fax_number": "484-526-2429"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERCULES",
        "first_name": "DECOSY",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-10-02",
        "last_updated": "2023-10-12",
        "certification_date": "2023-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "PA",
            "license": "OS018633",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bethlehem, PA

Sources for this page

Verify at the official NPI Registry.