St Luke's Physician Group, Inc

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

Legal business name

ST LUKE'S PHYSICIAN GROUP, INC

Doing business as

St. Luke's Surgical Advanced Practice Services

Practice address

801 Ostrum St
Bethlehem, PA 18015-1000

Phone

(484) 526-4641

Fax

(484) 526-3028

NPI assigned

Jan 21, 2022

Last updated

Jan 21, 2022By the provider in NPPES

Organization subpart

Yes

Parent organization

ST LUKE'S PHYSICIAN GROUP, INCAs reported in NPPES

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

Authorized official

Name

Elisha Amey

Title

Provider Enrollment Specialist

Phone

(484) 526-2538

Specialties & licenses 1

Addresses

Other names 1

• St. Luke's Surgical Advanced Practice Services Doing business as

Medicare fee-for-service enrollment

Enrolled in PA

Enrollment records 1

Part of

St Lukes Surgical Assoc

Practitioners 4

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.

• Katie Dodge, PAC

  • Physician Assistant
  • Bethlehem, PA
  • NPI 1659108637
  NPD
• Elizabeth Hung, PA-C

  • Physician Assistant
  • Bethlehem, PA
  • NPI 1053054429
  NPD
• Joanne P Mulligan, PA-C

  • Physician Assistant
  • Bethlehem, PA
  • NPI 1124072442
  NPD
• Susanna Parelman

  • Nurse Practitioner
  • Biddeford, ME
  • NPI 1841914801
  NPD

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

{
    "created_epoch": "1642723200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1642723200000",
    "number": "1598417404",
    "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": "484-526-2538"
        },
        {
            "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": "484-526-4641",
            "fax_number": "484-526-3028"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST LUKE'S PHYSICIAN GROUP, INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ST LUKE'S PHYSICIAN GROUP, INC",
        "enumeration_date": "2022-01-21",
        "last_updated": "2022-01-21",
        "certification_date": "2022-01-21",
        "status": "A",
        "authorized_official_last_name": "AMEY",
        "authorized_official_first_name": "ELISHA",
        "authorized_official_title_or_position": "PROVIDER ENROLLMENT SPECIALIST",
        "authorized_official_telephone_number": "484-526-2538"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "St. Luke's Surgical Advanced Practice Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• St Luke's Physician Group Inc (St. Luke's Baby and Me Support Center)
• St Luke's Physician Group Inc (St. Luke's Pediatric Specialists)
• St Luke's Physician Group Inc (St. Luke's Dental Health Center)
• St Luke's Physician Group Inc (St Luke's Acute Pain Service)
• St Luke's Physician Group, Inc (St. Luke's Wound Management)
• St Luke's Physician Group, Inc (St. Luke's Dermatopathology)
• St Luke's Physician Group, Inc. Dba St Luke's Bethlehem Primay Care
• St Lukes Homestar Services LLC (HomeStar Rx and Infusion Services)
• St Lukes Homestar Services LLC
• St Lukes Homestar Services LLC (HOMESTAR PHARMACY -Bethlehem)

• Surgical Physician Assistant in Bethlehem, PA
• Providers in Bethlehem, PA by specialty
• Surgical Physician Assistant in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2022; 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.