Individual provider Active NPI

Kimberley Polizzano, PA-C

  • Physician Assistant
  • Allentown, PA
National Provider Identifier
1407306095
Registry record updated Apr 22, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
MA058543 Issued in PA
Practice address
240 Cetronia Rd Ste 205N
Allentown, PA 18104-9263
Phone
(484) 426-2600
Fax
(833) 816-7512
NPI assigned
Oct 7, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2026

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 MA058543 PA Primary

Addresses

Primary practice location

240 Cetronia Rd Ste 205N
Allentown, PA 18104-9263

Mailing address

240 Cetronia Rd Ste 205N
Allentown, PA 18104-9263
Phone (484) 426-2600

Other identifiers 1

IdentifierTypeStateIssuer
034134OtherPAMEDICARE GROUP

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
I20161206001792 PA Practitioner - Physician Assistant 5991085045 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2016
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)

306 S New St
Bethlehem, PA 18015-1652

306 S New Street
Bethlehem, PA 18015-1652

801 Ostrm St
Bethlehem, PA 18015-1000

Hospital & facility affiliations

  • St Lukes Hospital Hospital, Bethlehem, PA, CCN 390049

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

Practice roles

OrganizationSpecialtyStatusNew patients
St. Luke'S Physician Group, Inc. CurrentSince Oct 24, 2016 Accepting new patients
St Luke'S Physician Group Inc CurrentSince Oct 24, 2016 Accepting new patients
St. Luke'S Physician Group, Inc Past Accepting new patients

Locations

240 Cetronia Rd
Ste 200N
Allentown, PA 18104
Phone (484) 426-2600

240 Cetronia Rd
Ste 205N
Allentown, PA 18104
Phone (484) 426-2600

1521 8th Ave
Ste 201
Bethlehem, PA 18018
Phone (610) 882-2598

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

Interoperability endpoints

  • Direct secure messaging: kimberley.pollizzano@slpg.direct-sluhn.org

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 and National Provider Directory roles.

Hospital & facility affiliations 6

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": "1475798400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776816000000",
    "number": "1407306095",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "240 CETRONIA RD STE 205N",
            "city": "ALLENTOWN",
            "state": "PA",
            "postal_code": "181049263",
            "telephone_number": "484-426-2600",
            "fax_number": "833-816-7512"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "240 CETRONIA RD STE 205N",
            "city": "ALLENTOWN",
            "state": "PA",
            "postal_code": "181049263",
            "telephone_number": "484-426-2600",
            "fax_number": "833-816-7512"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POLIZZANO",
        "first_name": "KIMBERLEY",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-10-07",
        "last_updated": "2026-04-22",
        "certification_date": "2026-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA058543",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP",
            "identifier": "034134",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Allentown, PA

Sources for this page

Verify at the official NPI Registry.