NPIMap

Individual provider Active NPI

Devon M Bizarre, PA-C

  • Physician Assistant
  • Coaldale, PA
National Provider Identifier
1396212767
Registry record updated Oct 24, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
OA004682 Issued in PA
Practice address
360 W Ruddle St
Coaldale, PA 18218-1027
Phone
(570) 645-2131
NPI assigned
Oct 24, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 24, 2018

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 OA004682 PA Primary

Addresses

Primary practice location

360 W Ruddle St
Coaldale, PA 18218-1027

Mailing address

801 Ostrum St
Bethlehem, PA 18015-1000

Other practice location 1

801 Ostrum St
Bethlehem, PA 18015-1000
Phone (484) 526-4000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, NJ2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20181218003949 PA Practitioner - Physician Assistant 6901141043 Reassigns benefits to 2 organizations
I20240920002393 NJ Practitioner - Physician Assistant 6901141043 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Gslpg, IncGroup PAC ID 7810226875, 269 clinicians
St Lukes Physician Group IncGroup PAC ID 6709798333, 2,161 clinicians

Practice addresses (Care Compare)

100 Paramount Blvd
Orwigsburg, PA 17961-2202
Phone (484) 526-2440

360 W Riddle St
Coaldale, PA 18218-1027

500 St Lukes Dr
Lehighton, PA 18235-5000
Phone (484) 526-2200

801 Ostrm St
Bethlehem, PA 18015-1000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
97.13 of 100Reported as apm
Quality
82.27
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
OA004682PAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
St Luke'S Physician Group Inc CurrentSince Oct 23, 2018 Accepting new patients
St. Luke'S Warren Physician Group, PC CurrentSince Aug 1, 2024 Accepting new patients
St Luke'S Physician Group Inc CurrentSince Oct 23, 2018 Accepting new patients
St. Luke'S Warren Physician Group, PC CurrentSince Aug 1, 2024 Accepting new patients
St. Luke'S Physician Group, Inc Past Accepting new patients
Gslpg Inc Past Accepting new patients
Gslpg Inc Past Accepting new patients
St. Luke'S Physician Group, Inc. Past Accepting new patients

Locations

123B Roseberry St
Phillipsburg, NJ 08865
Phone (908) 213-3433

185 Roseberry St
Bldg 2ND
Phillipsburg, NJ 08865
Phone (908) 847-2619

279 State Route 31 S
Washington, NJ 07882
Phone (908) 689-2201

3050 Hamilton Blvd
Ste 110
Allentown, PA 18103
Phone (484) 223-3300

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

1165 Centre Tpke
Orwigsburg, PA 17961
Phone (272) 639-5130

100 Paramount Blvd
#3
Orwigsburg, PA 17961

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

3000 St Lukes Dr
Ste 2
Quakertown, PA 18951

700 Lawn Ave
Sellersville, PA 18960
Phone (215) 453-4000

4 Life Mark Dr
Sellersville, PA 18960
Phone (215) 453-4026

Interoperability endpoints

  • Direct secure messaging: devon.bizarre@slpg.direct-sluhn.org

Organizations & group practices 11

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 9

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": "1540339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1540339200000",
    "number": "1396212767",
    "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"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "360 W RUDDLE ST",
            "city": "COALDALE",
            "state": "PA",
            "postal_code": "182181027",
            "telephone_number": "570-645-2131"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "801 Ostrum St",
            "address_purpose": "LOCATION",
            "city": "Bethlehem",
            "state": "PA",
            "postal_code": "180151000",
            "country_code": "US",
            "telephone_number": "484-526-4000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BIZARRE",
        "first_name": "DEVON",
        "middle_name": "M",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-10-24",
        "last_updated": "2018-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "OA004682",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Coaldale, PA

Sources for this page

Verify at the official NPI Registry.