NPIMap

Organization Active NPI

St. Luke's Physician Group Inc.

Doing business as St. Luke's Family Practice Clinic at Donegan

  • Family Medicine Physician
  • Bethlehem, PA
National Provider Identifier
1508244526
Registry record updated May 14, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
ST. LUKE'S PHYSICIAN GROUP INC.
Doing business as
St. Luke's Family Practice Clinic at Donegan
Practice address
1210 E 4TH St
Bethlehem, PA 18015-2016
Phone
(610) 849-9157
Fax
(484) 821-0062
NPI assigned
May 11, 2015
Last updated
May 14, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 14, 2015

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

Authorized official

Name
Dean W. Evans
Title
President
Phone
(484) 526-4991

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X Primary

Addresses

Primary practice location

1210 E 4TH St
Bethlehem, PA 18015-2016

Mailing address

1210 E 4TH St
Bethlehem, PA 18015-2016
Phone (610) 849-9157

Other names 1

  • St. Luke's Family Practice Clinic at Donegan Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040226000062 PA Part B Supplier - Clinic/Group Practice 6709798333 Receives reassigned benefits from 3,523 practitioners
This NPI is an additional NPI on the enrollment

National Provider Directory

National Provider Directory
Tax ID family
Saucon Valley Family PR165 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Locations

3000 Fellowship Dr
Whitehall, PA 18052
Phone (610) 776-3278

Practitioners & affiliated clinicians

Practitioners 9

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1431302400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1431561600000",
    "number": "1508244526",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1210 E 4TH ST",
            "city": "BETHLEHEM",
            "state": "PA",
            "postal_code": "180152016",
            "telephone_number": "610-849-9157",
            "fax_number": "484-821-0062"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1210 E 4TH ST",
            "city": "BETHLEHEM",
            "state": "PA",
            "postal_code": "180152016",
            "telephone_number": "610-849-9157",
            "fax_number": "484-821-0062"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST. LUKE'S PHYSICIAN GROUP INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-05-11",
        "last_updated": "2015-05-14",
        "status": "A",
        "authorized_official_last_name": "EVANS",
        "authorized_official_first_name": "DEAN",
        "authorized_official_middle_name": "W.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "484-526-4991"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "St. Luke's Family Practice Clinic at Donegan",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bethlehem, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.