Individual provider Active NPI

Ian W. Sale, PAC

  • Medical Physician Assistant
  • Bethlehem, PA
National Provider Identifier
1568612125
Registry record updated Sep 19, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
MA053602 Issued in PA
Practice address
801 Ostrum St
Bethlehem, PA 18015-1000
Phone
(610) 954-2200
Fax
(610) 954-2200
NPI assigned
Sep 19, 2008
Last updated
Sep 19, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X MA053602 PA Primary

Addresses

Primary practice location

801 Ostrum St
Bethlehem, PA 18015-1000

Mailing address

801 Ostrum St
Bethlehem, PA 18015-1000
Phone (610) 954-2200

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081107000275 PA Practitioner - Physician Assistant 7810056645 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Main Line HealthcareGroup PAC ID 1951215201, 1,154 clinicians

Practice addresses (Care Compare)

255 W Lancaster Ave
Paoli, PA 19301-1763

830 Old Lancaster Rd
Bryn Mawr, PA 19010-3118

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Lanaster General Hospital CurrentSince Oct 19, 2009 Accepting new patients
Lancaster General Hospital CurrentSince Oct 19, 2009 Accepting new patients
Lancaster General Medical Group CurrentSince Feb 26, 2018 Accepting new patients
Lancaster General Medical Group CurrentSince Feb 26, 2018 Accepting new patients

Locations

426 Cloverleaf Rd
Elizabethtown, PA 17022
Phone (717) 299-1301

554 N Duke St
Lancaster, PA 17602
Phone (717) 291-5863

555 N Duke St
Lancaster, PA 17602
Phone (717) 544-5945

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

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": "1221782400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1221782400000",
    "number": "1568612125",
    "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": "610-954-2200",
            "fax_number": "610-954-2200"
        },
        {
            "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": "610-954-2200",
            "fax_number": "610-954-2200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SALE",
        "first_name": "IAN",
        "middle_name": "W.",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-09-19",
        "last_updated": "2008-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "PA",
            "license": "MA053602",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bethlehem, PA

Sources for this page

Verify at the official NPI Registry.