NPIMap

Individual provider Active NPI

Aedan Simon Ampong Olaso, MD

  • Nephrology Physician
  • Allentown, PA
National Provider Identifier
1417268996
Registry record updated Jun 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
MD456169 Issued in PA
Practice address
1230 S Cedar Crest Blvd Stes 301, 302, 304
Allentown, PA 18103-6212
Phone
(610) 432-4529
Fax
(610) 432-2206
NPI assigned
Jun 29, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 2, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X MD456169 PA Primary

Addresses

Primary practice location

1230 S Cedar Crest Blvd Stes 301, 302, 304
Allentown, PA 18103-6212

Mailing address

1230 S Cedar Crest Blvd Ste 301
Allentown, PA 18103-6212
Phone (610) 432-4529

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address aolaso12171@direct.acumenmd.com

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
I20151104002942 PA Practitioner - NephrologyPractitioner - Internal MedicinePractitioner - Neurology 1850532318 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
NephrologyAlso: Internal Medicine
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Valley Kidney Specialists, P.C.Group PAC ID 2860670734, 31 clinicians

Practice addresses (Care Compare)

1230 S Cedar Crest Blvd
Allentown, PA 18103-6212
Phone (610) 432-4529

175 S 21St St
Easton, PA 18042-3835
Phone (610) 258-3608

292 E Brown St
East Stroudsburg, PA 18301-3006
Phone (570) 424-9443

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD456169PAMDNephrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Valley Kidney Specialists, P.C. Nephrology CurrentSince Nov 1, 2015 Accepting new patients
Valley Kidney Specialists, PC Nephrology CurrentSince Nov 1, 2015 Accepting new patients
Kidney Care Specialists LLC Nephrology CurrentSince Nov 1, 2018 Accepting new patients

Locations

1230 S Cedar Crest Blvd
Ste 301
Allentown, PA 18103
Phone (610) 432-4873

1230 S Cedar Crest Blvd
Ste 30130
Allentown, PA 18103

1230 S Cedar Crest Blvd
Ste 304
Allentown, PA 18103
Phone (452) 961-0432

2014 City Line Rd
Ste 103
Bethlehem, PA 18017
Phone (610) 433-4100

2000 Sproul Rd
Ste 300
Broomall, PA 19008
Phone (610) 356-3700

175 S 21st St
Easton, PA 18042
Phone (610) 253-4898

55 N 3rd St
Stroudsburg, PA 18360
Phone (570) 424-9443

525 E West St
Wind Gap, PA 18091
Phone (610) 258-3608

Interoperability endpoints

  • Direct secure messaging: aolaso12171@direct.acumenmd.com

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 13

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1277769600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654128000000",
    "number": "1417268996",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1230 S CEDAR CREST BLVD STE 301",
            "city": "ALLENTOWN",
            "state": "PA",
            "postal_code": "181036212",
            "telephone_number": "610-432-4529",
            "fax_number": "610-432-2206"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1230 S CEDAR CREST BLVD STES 301, 302, 304",
            "city": "ALLENTOWN",
            "state": "PA",
            "postal_code": "181036212",
            "telephone_number": "610-432-4529",
            "fax_number": "610-432-2206"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLASO",
        "first_name": "AEDAN",
        "middle_name": "SIMON AMPONG",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-06-29",
        "last_updated": "2022-06-02",
        "certification_date": "2022-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "PA",
            "license": "MD456169",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "aolaso12171@direct.acumenmd.com",
            "affiliation": "N",
            "address_1": "1230 S Cedar Crest Blvd Stes 301, 302, 304",
            "city": "Allentown",
            "state": "PA",
            "country_code": "US",
            "postal_code": "181036212",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Allentown, PA

Sources for this page

Verify at the official NPI Registry.