NPIMap

Individual provider Active NPI

Andrei Vedeniapin, M.D.

  • Psychiatry Physician
  • Bethlehem, PA
National Provider Identifier
1508078791
Registry record updated Jun 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
L30734 Issued in SC
Practice address
801 Ostrum St
Bethlehem, PA 18015-1000
Phone
(484) 526-4000
NPI assigned
May 3, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2021

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 L30734 SC Primary

Addresses

Primary practice location

801 Ostrum St
Bethlehem, PA 18015-1000

Mailing address

801 Ostrum St
Bethlehem, PA 18015-1000
Phone (484) 526-3569

Other practice location 1

67 President St
515 South
Charleston, SC 29425-5712
Phone (843) 792-0306

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
I20150331000567 PA Practitioner - Psychiatry 2163560236 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 1985
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)

211 N 12 St
Lehighton, PA 18235-1138

421 Chew St
Allentown, PA 18102-3406
Phone (484) 503-1018

421 W Chew St
Allentown, PA 18102-3406
Phone (610) 776-4959

451 Chew St
Suite 404
Allentown, PA 18102-3424
Phone (484) 526-7576

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
L30734SCMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Penn Foundation Inc CurrentSince Jul 1, 2022 Accepting new patients
St. Luke's Physician Group, Inc. Psychiatry CurrentSince Feb 4, 2015 Accepting new patients
St Luke's Physician Group Inc CurrentSince Feb 4, 2015 Accepting new patients
St. Luke's Physician Group, Inc. Current Accepting new patients
St. Luke's Hospital Past Accepting new patients

Locations

1107 Eaton Ave
Bethlehem, PA 18018
Phone (610) 954-3012

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

807 Lawn Ave
Sellersville, PA 18960

Interoperability endpoints

  • Direct secure messaging: andrei.vedeniapin@slpg.direct-sluhn.org

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 7

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": "1178150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624406400000",
    "number": "1508078791",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 OSTRUM ST",
            "city": "BETHLEHEM",
            "state": "PA",
            "postal_code": "180151000",
            "telephone_number": "484-526-3569"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 OSTRUM ST",
            "city": "BETHLEHEM",
            "state": "PA",
            "postal_code": "180151000",
            "telephone_number": "484-526-4000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "67 President St",
            "address_2": "515 South",
            "address_purpose": "LOCATION",
            "city": "Charleston",
            "state": "SC",
            "postal_code": "294255712",
            "country_code": "US",
            "telephone_number": "843-792-0306",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VEDENIAPIN",
        "first_name": "ANDREI",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-03",
        "last_updated": "2021-06-23",
        "certification_date": "2021-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "SC",
            "license": "L30734",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bethlehem, PA

Sources for this page

Verify at the official NPI Registry.