Individual provider Active NPI

Nicole Lynn Grube, D.O.

  • Hospitalist Physician
  • Bethlehem, PA
National Provider Identifier
1487809711
Registry record updated Sep 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
OS015824 Issued in PA
Practice address
2545 Schoenersville Rd
Bethlehem, PA 18017-7300
Phone
(484) 884-9677
Fax
(484) 884-9297
NPI assigned
Dec 1, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 21, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hospitalist Physician 208M00000X OS015824 PA Primary

Addresses

Primary practice location

2545 Schoenersville Rd
Bethlehem, PA 18017-7300

Mailing address

PO Box 783311
Philadelphia, PA 19178-3311
Phone (484) 884-4500

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120314000642 PA Practitioner - Internal Medicine 5193984987 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Philadelphia College of Osteopathic Medicine, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lehigh Valley Physician GroupGroup PAC ID 3072425123, 2,512 clinicians

Practice addresses (Care Compare)

1210 S Cedar Crest Blvd
Allentown, PA 18103-6235
Phone (610) 402-3888

2100 Mack Blvd
FL 4
Allentown, PA 18103-5622

2545 Schoenersville Rd
Bethlehem, PA 18017-7300

3780 Hecktown Rd
Easton, PA 18045-2355
Phone (610) 333-8888

3794 Hecktown Rd
Easton, PA 18045-2355

5649 Wynnewood Dr
Laurys Station, PA 18059-1124

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
OS015824PAMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lehigh Valley Physician Group Internal Medicine Current Accepting new patients
Lehigh Valley Physician Group CurrentSince Mar 19, 2012 Accepting new patients
Lehigh Valley Physician Group Internal Medicine CurrentSince Mar 19, 2012 Accepting new patients
Lehigh Valley Hospital Past Accepting new patients

Locations

2100 Mack Blvd
Fl 2
Allentown, PA 18103

2545 Schoenersville Rd
Bethlehem, PA 18017
Phone (484) 884-2888

5649 Wynnewood Dr
Ste 104
Laurys Station, PA 18059
Phone (610) 262-6641

Organizations & group practices 5

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 5

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": "1228089600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695254400000",
    "number": "1487809711",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 783311",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191783311",
            "telephone_number": "484-884-4500",
            "fax_number": "484-884-0699"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2545 SCHOENERSVILLE RD",
            "city": "BETHLEHEM",
            "state": "PA",
            "postal_code": "180177300",
            "telephone_number": "484-884-9677",
            "fax_number": "484-884-9297"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRUBE",
        "first_name": "NICOLE",
        "middle_name": "LYNN",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-12-01",
        "last_updated": "2023-09-21",
        "certification_date": "2023-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "PA",
            "license": "OS015824",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bethlehem, PA

Sources for this page

Verify at the official NPI Registry.