Individual provider Active NPI

Todd Michael Zoltack, PA-C

  • Physician Assistant
  • Bethlehem, PA
National Provider Identifier
1366699084
Registry record updated Aug 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
OA002271 Issued in PA
Practice address
153 Brodhead Rd
Bethlehem, PA 18017-8931
Phone
(484) 526-3000
Fax
(484) 526-3030
NPI assigned
Aug 25, 2008
Last updated
Aug 15, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X OA002271 PA Primary

Addresses

Primary practice location

153 Brodhead Rd
Bethlehem, PA 18017-8931

Mailing address

153 Brodhead Rd
Bethlehem, PA 18017-8931
Phone (484) 526-3000

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090526000159 PA Practitioner - Physician Assistant 1456400332 Reassigns benefits to 7 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Luke's HospitalGroup PAC ID 0648189688, 100 clinicians
GSL HospitalGroup PAC ID 8921338583, 23 clinicians

Practice addresses (Care Compare)

1104 N St
St Luke's Care Now
Jim Thorpe, PA 18229-1717
Phone (570) 325-2400

120 Pine St
Tamaqua, PA 18252-1409
Phone (570) 645-1500

15065 Kutztown Rd
Kutztown, PA 19530-9276
Phone (484) 822-8001

153 Brodhead Rd
Bethlehem, PA 18017-8931
Phone (484) 526-3218

2003 Sullivan TRL
Easton, PA 18040-8339
Phone (484) 503-6470

2650 Woodglen Rd
Geisinger St Luke's Care Now Pottsville
Pottsville, PA 17901-1335
Phone (272) 639-5780

2701 Shillington Rd
Suite 100
Reading, PA 19608-1732
Phone (484) 822-6170

360 W Riddle St
Coaldale, PA 18218-1027
Phone (570) 645-8127

60 Cherry St
Suite 210
Leesport, PA 19533-8503
Phone (484) 526-4000

9 Dave's Way
Hamburg, PA 19526-1463
Phone (610) 628-7201

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
OA002271PAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
St. Luke's Hospital - Anderson Campus CurrentSince Jul 10, 2023 Accepting new patients
GSL Hospital CurrentSince Jul 10, 2023 Accepting new patients
St. Luke's Quakertown Hospital CurrentSince May 1, 2017 Accepting new patients
St Luke's Hospital CurrentSince May 1, 2018 Accepting new patients
St. Luke's Hosptial CurrentSince Jul 10, 2023 Accepting new patients
St. Luke's Quakertown Hospital CurrentSince May 1, 2017 Accepting new patients
St. Luke's Hospital Monroe Campus CurrentSince Nov 21, 2017 Accepting new patients
St. Luke's Hospital Monroe Campus CurrentSince Nov 21, 2017 Accepting new patients
The Carbon Schuylkill Community Hospital, Inc. CurrentSince Apr 1, 2017 Accepting new patients
St Luke's Physician Group Inc CurrentSince Apr 26, 2011 Accepting new patients
Carbon Schuylkill Community Hospital, Inc. CurrentSince Apr 1, 2017 Accepting new patients
St. Luke's Physician Group Inc CurrentSince Apr 26, 2011 Accepting new patients
St Luke's Hospital CurrentSince May 1, 2018 Accepting new patients
Macungie Medical Group PC Past Accepting new patients

Locations

153 Brodhead Rd
Bethlehem, PA 18017
Phone (484) 526-3200

4311 Easton Ave
Bethlehem, PA 18020
Phone (610) 954-3600

111 Route 715
Brodheadsvlle, PA 18322
Phone (272) 212-0420

2461 Nazareth Rd
Easton, PA 18045
Phone (610) 252-1020

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

1104 North St
Jim Thorpe, PA 18229
Phone (570) 325-2400

3760 Brookside Rd
Macungie, PA 18062
Phone (610) 770-2708

2650 Woodglen Rd
Pottsville, PA 17901
Phone (272) 639-5755

487 E Moorestown Rd
Wind Gap, PA 18091
Phone (484) 526-7850

Interoperability endpoints

  • Direct secure messaging: todd.zoltack@slpg.direct-sluhn.org

Organizations & group practices 18

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.

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1219622400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755216000000",
    "number": "1366699084",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "153 BRODHEAD RD",
            "city": "BETHLEHEM",
            "state": "PA",
            "postal_code": "180178931",
            "telephone_number": "484-526-3000",
            "fax_number": "484-526-3030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "153 BRODHEAD RD",
            "city": "BETHLEHEM",
            "state": "PA",
            "postal_code": "180178931",
            "telephone_number": "484-526-3000",
            "fax_number": "484-526-3030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZOLTACK",
        "first_name": "TODD",
        "middle_name": "MICHAEL",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-08-25",
        "last_updated": "2025-08-15",
        "certification_date": "2025-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "OA002271",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bethlehem, PA

Sources for this page

Verify at the official NPI Registry.