Individual provider Active NPI

Nicole Renee Beidler, PA-C

  • Medical Physician Assistant
  • Bethlehem, PA
National Provider Identifier
1609109149
Registry record updated Apr 1, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
MA054105 Issued in PA
Practice address
2545 Schoenersville Rd
2ND Floor Tower
Bethlehem, PA 18017-7300
Phone
(484) 884-9677
NPI assigned
Sep 16, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 1, 2019

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 MA054105 PA Primary

Addresses

Primary practice location

2545 Schoenersville Rd
2ND Floor Tower
Bethlehem, PA 18017-7300

Mailing address

PO Box 783311
Philadelphia, PA 19178-3311

Other names 1

  • Nicole Renee Sansone Former name

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
I20091014000476 PA Practitioner - Physician Assistant 2062558554 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lehigh Valley Physician GroupGroup PAC ID 3072425123, 2,512 clinicians

Practice addresses (Care Compare)

1210 S Cedar Crest Blvd
Allentown, PA 18103-6235
Phone (610) 402-3888

2545 Schoenersville Rd
Bethlehem, PA 18017-7300

3780 Hecktown Rd
Easton, PA 18045-2355
Phone (610) 333-8888

3794 Hecktown Rd
Easton, PA 18045-2355

5649 Wynnewood Dr
Laurys Station, PA 18059-1124

Hospital & facility affiliations

  • Lehigh Valley Hospital Hospital, Allentown, PA, CCN 390133

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Lehigh Valley Physician Group CurrentSince May 14, 2017 Accepting new patients
Lehigh Valley Physician Group CurrentSince May 14, 2017 Accepting new patients
Pulmonary Associates PC Past Accepting new patients

Locations

1730 Chew St
Allentown, PA 18104
Phone (610) 402-3500

2545 Schoenersville Rd
Fl 2
Bethlehem, PA 18017
Phone (484) 884-5666

5649 Wynnewood Dr
Ste 104
Laurys Station, PA 18059
Phone (610) 262-6641

2128 Blakeslee Boulevard Dr E
Lehighton, PA 18235
Phone (484) 224-9970

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.

Hospital & facility affiliations 5

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": "1253059200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1554076800000",
    "number": "1609109149",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 783311",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191783311"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2545 SCHOENERSVILLE RD",
            "address_2": "2ND FLOOR TOWER",
            "city": "BETHLEHEM",
            "state": "PA",
            "postal_code": "180177300",
            "telephone_number": "484-884-9677"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEIDLER",
        "first_name": "NICOLE",
        "middle_name": "RENEE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-09-16",
        "last_updated": "2019-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "PA",
            "license": "MA054105",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NICOLE",
            "last_name": "SANSONE",
            "middle_name": "RENEE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Bethlehem, PA

Sources for this page

Verify at the official NPI Registry.