NPIMap

Individual provider Active NPI

Max E Widawski, DO

  • Internal Medicine Physician
  • Allentown, PA
National Provider Identifier
1619468733
Registry record updated Dec 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
OS021474 Issued in PA
Practice address
1901 Hamilton St Ste 300
Allentown, PA 18104-6461
Phone
(610) 628-7900
Fax
(833) 816-7513
NPI assigned
May 24, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 14, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X OS021474 PA Primary
Internal Medicine Physician 207R00000X OT018253 PA

Addresses

Primary practice location

1901 Hamilton St Ste 300
Allentown, PA 18104-6461

Mailing address

801 Ostrum St
Bethlehem, PA 18015-1000
Phone (484) 526-6048

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211203001350 PA Practitioner - Internal Medicine 4284024373 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Philadelphia College of Osteopathic Medicine, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
St Lukes Physician Group IncGroup PAC ID 6709798333, 2,161 clinicians

Practice addresses (Care Compare)

1901 Hamilton St
Suite 300
Allentown, PA 18104-6461
Phone (610) 628-7900

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
97.13 of 100Reported as apm
Quality
82.27
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
OT018253PAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St. Luke'S Physician Group Inc. CurrentSince Aug 21, 2021 Accepting new patients
St Luke'S Physician Group Inc CurrentSince Aug 21, 2021 Accepting new patients
St. Luke'S Physician Group, Inc. Current Accepting new patients
St. Luke'S Physician Group, Inc Past Accepting new patients

Locations

1901 Hamilton St
Ste 300
Allentown, PA 18104
Phone (610) 628-7900

4311 Easton Ave
Bethlehem, PA 18020
Phone (610) 954-3600

801 Ostrum St
Fountain Hill, PA 18015
Phone (610) 954-2200

Interoperability endpoints

  • Direct secure messaging: max.widawski@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.

Hospital & facility affiliations 18

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1527120000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639440000000",
    "number": "1619468733",
    "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": "484-526-6048",
            "fax_number": "833-213-6428"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1901 HAMILTON ST STE 300",
            "city": "ALLENTOWN",
            "state": "PA",
            "postal_code": "181046461",
            "telephone_number": "610-628-7900",
            "fax_number": "833-816-7513"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIDAWSKI",
        "first_name": "MAX",
        "middle_name": "E",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-05-24",
        "last_updated": "2021-12-14",
        "certification_date": "2021-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "OS021474",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "OT018253",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Allentown, PA

Sources for this page

Verify at the official NPI Registry.