NPIMap

Individual provider Active NPI

Welda Donato-Duque, MD

  • Psychiatry Physician
  • Allentown, PA
National Provider Identifier
1417042672
Registry record updated Jul 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
MD060883L Issued in PA
Practice address
1411 Union Blvd
Allentown, PA 18109-2423
Phone
(610) 433-6181
Fax
(610) 433-5124
NPI assigned
Oct 4, 2006
Last updated
Jul 17, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X MD060883L PA Primary

Addresses

Primary practice location

1411 Union Blvd
Allentown, PA 18109-2423

Mailing address

1696 Kevin Dr
Bethlehem, PA 18015-5510

Other identifiers 1

IdentifierTypeStateIssuer
001626612MedicaidPA

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
I20070619000299 PA Practitioner - Psychiatry 7618076563 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 1980
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Haven HouseGroup PAC ID 3476536780, 9 clinicians

Practice addresses (Care Compare)

1411 Union Blvd
Allentown, PA 18109-1505
Phone (610) 433-6181

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Haven House CurrentSince Jun 5, 2024 Accepting new patients
Kidspeace Childrens Hospital Past Accepting new patients

Locations

1411 Union Blvd
Allentown, PA 18109
Phone (610) 351-6189

1530 Hanover Ave
Allentown, PA 18109
Phone (610) 433-6181

Organizations & group practices 2

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 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": "1159920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721174400000",
    "number": "1417042672",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1696 KEVIN DR",
            "city": "BETHLEHEM",
            "state": "PA",
            "postal_code": "180155510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1411 UNION BLVD",
            "city": "ALLENTOWN",
            "state": "PA",
            "postal_code": "181092423",
            "telephone_number": "610-433-6181",
            "fax_number": "610-433-5124"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DONATO-DUQUE",
        "first_name": "WELDA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-04",
        "last_updated": "2024-07-17",
        "certification_date": "2024-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "PA",
            "license": "MD060883L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001626612",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Allentown, PA

Sources for this page

Verify at the official NPI Registry.