NPIMap

Individual provider Active NPI

Fabio Lopes Dorville, M.D.

  • Internal Medicine Physician
  • Fountain Hill, PA
National Provider Identifier
1396794913
Registry record updated Aug 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD037390-L Issued in PA
Practice address
1130 Delaware Ave
Fountain Hill, PA 18015-4117
Phone
(610) 868-2710
Fax
(610) 868-6130
NPI assigned
May 9, 2006
Last updated
Aug 9, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD037390-L PA Primary

Addresses

Primary practice location

1130 Delaware Ave
Fountain Hill, PA 18015-4117

Mailing address

1130 Delaware Ave
Fountain Hill, PA 18015-4117
Phone (610) 868-2710

Other identifiers 1

IdentifierTypeStateIssuer
109772OtherPABLUE SHIELD

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
I20110330000651 PA Practitioner - Internal Medicine 9436162682 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1974
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
St Lukes Physician Group IncGroup PAC ID 6709798333, 2,161 clinicians

Practice addresses (Care Compare)

1130 Delaware Ave
Fountain Hill, PA 18015-4117
Phone (610) 868-2710

4311 Easton Ave
Bethlehem, PA 18020-1431
Phone (610) 954-3600

4379 Easton Ave
101 Family Prac Palmer
Bethlehem, PA 18020-1431
Phone (610) 814-2424

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
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD037390-LPAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St. Luke's Physician Group, Inc. CurrentSince Sep 1, 2020 Accepting new patients
St. Luke's Physician Group, Inc. Current Accepting new patients
St Luke's Physician Group Inc CurrentSince Sep 1, 2020 Accepting new patients
St Lukes Hospital Past Accepting new patients

Locations

2830 Easton Ave
Bethlehem, PA 18017
Phone (484) 526-3555

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

5325 Northgate Dr
Ste 201
Bethlehem, PA 18017
Phone (610) 625-4400

1130 Delaware Ave
Fountain Hill, PA 18015
Phone (610) 868-2710

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

Organizations & group practices 4

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.

Hospital & facility affiliations 12

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": "1147132800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1186617600000",
    "number": "1396794913",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1130 DELAWARE AVE",
            "city": "FOUNTAIN HILL",
            "state": "PA",
            "postal_code": "180154117",
            "telephone_number": "610-868-2710",
            "fax_number": "610-868-6130"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1130 DELAWARE AVE",
            "city": "FOUNTAIN HILL",
            "state": "PA",
            "postal_code": "180154117",
            "telephone_number": "610-868-2710",
            "fax_number": "610-868-6130"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DORVILLE",
        "first_name": "FABIO",
        "middle_name": "LOPES",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-09",
        "last_updated": "2007-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MD037390-L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "109772",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fountain Hill, PA

Sources for this page

Verify at the official NPI Registry.