Active NPI
Alexander Kokolus, CRNP
- Nurse Practitioner
- Bowmanstown, PA
National Provider Identifier
1558037408
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- SP022696
- Practice address
- 512 Bank St
Bowmanstown, PA 18030-0010 - Phone
- (484) 526-2400
- NPI assigned
- Aug 20, 2021
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | SP022696 | PA | Primary |
Addresses
Primary practice location
512 Bank St
Bowmanstown, PA 18030-0010
Mailing address
801 Ostrum St
Bethlehem, PA 18015-1000
Phone (484) 526-4000
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: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20211018002818 | PA | Practitioner - Nurse Practitioner | 2264830546 | Reassigns benefits to 2 organizations |
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2020
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- St Lukes Physician Group Inc
Practice addresses (Care Compare)
512 Bank St
St Lukes Psychiatric Associates
Bowmanstown, PA 18030-0010
Phone (484) 526-2400
Hospital & facility affiliations
- St Lukes Hospital
Merit-based Incentive Payment System (MIPS)
- Final score
- 97.13 of 100
- Quality
- 82.27
- Promoting interoperability
- 100
- Improvement activities
- 40
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| SP022696 | PA | MD | Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| St. Luke'S Physician Group, Inc. | Current | Accepting new patients | |
| Penn Foundation Inc | Current | Accepting new patients | |
| St. Luke'S Physician Group, Inc. | Current | Accepting new patients | |
| St Luke'S Physician Group Inc | Current | Accepting new patients |
Locations
801 Ostrum St
Fountain Hill, PA 18015
Phone (610) 954-2200
807 Lawn Ave
Sellersville, PA 18960
Interoperability endpoints
- alexander.kokolus@slpg.direct-sluhn.org
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.
-
- Family Medicine Physician
- Orwigsburg, PA
- NPI 1710845144
-
- Psychiatry Physician
- Bowmanstown, PA
- NPI 1376107235
Hospital & facility affiliations 6
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Adult Mental Health Clinic/Center
- Lehighton, PA
- NPI 1962094920
Hospital
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1629417600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1629417600000",
"number": "1558037408",
"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": "484-526-4000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "512 BANK ST",
"city": "BOWMANSTOWN",
"state": "PA",
"postal_code": "180300010",
"telephone_number": "484-526-2400"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KOKOLUS",
"first_name": "ALEXANDER",
"credential": "CRNP",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-08-20",
"last_updated": "2021-08-20",
"certification_date": "2021-08-03",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "PA",
"license": "SP022696",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bowmanstown, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.