St. Luke'S Physician Group Inc.
Organization Active NPI Infectious Disease Physician · Easton, PA
NPI 1588043376 · NPPES record last updated Nov 30, 2015
Key facts
- NPI
- 1588043376
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Infectious Disease Physician 207RI0200X
- Legal business name
- ST. LUKE'S PHYSICIAN GROUP INC.
- Practice address
- 100 N 3Rd St
2ND Floor
Easton, PA 18042-1869 - Phone
- (484) 503-8010
- Fax
- (484) 503-8009
- NPI assigned
- May 26, 2015
- Organization subpart
- No
Authorized official
- Name
- Dean W. Evans
- Title
- President
- Phone
- (484) 526-4991
Corporate family (same tax ID) 24
Practitioners 9
-
Wassim Abosamra, M.D
-
Vanessa Cameron, D.O.
-
Jill Lechner, CRNP
-
Jesse A Newman, MD
-
Marija S Rice, CRNP
-
Chelsea Tripp Shepherd, CRNP
-
Cosme Rolando Peccerelli, RPAC
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in PA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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
- Tax ID family
- Upper Bucks Emergency M
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician |
207Q00000X | |||
| Infectious Disease Physician |
207RI0200X | Yes |
Addresses
Primary practice location
100 N 3Rd St
2ND Floor
Easton, PA 18042-1869
Mailing address
100 N 3Rd St
2ND Floor
Easton, PA 18042-1869
Phone (484) 503-8010
Other names
- ASC at St. Luke's Hospital
Other providers in Easton, PA
- St. Luke'S Physician Group Inc
- St. Luke'S Physician Group Inc
- St. Luke'S Physician Group Inc
- St. Luke'S Physician Group Inc.
- St. Luke'S Physician Group Inc.
- St. Luke'S Physician Group Inc., Dba
- St. Luke'S Physician Group, Inc
- St. Luke'S Physician Group, Inc
- St. Luke'S Physician Group, Inc
- St. Luke'S Physician Group, Inc
All providers in Easton, PA · Infectious Disease Physician in Pennsylvania
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 30, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.