NPIMap

Organization Active NPI

St. Luke's Warren Physician Group, PC

Doing business as St. Luke's Center for Urology Warren

  • Urology Physician
  • Phillipsburg, NJ
National Provider Identifier
1619618030
Registry record updated Mar 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
Legal business name
ST. LUKE'S WARREN PHYSICIAN GROUP, PC
Doing business as
St. Luke's Center for Urology Warren
Practice address
755 Memorial Pkwy Ste 207
Phillipsburg, NJ 08865-2773
Phone
(484) 526-2598
Fax
(866) 522-4710
NPI assigned
Apr 7, 2022
Last updated
Mar 17, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2023

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

Authorized official

Name
Sue Chiavaroli
Title
Manager
Phone
(484) 526-3569

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208800000X Primary

Addresses

Primary practice location

755 Memorial Pkwy Ste 207
Phillipsburg, NJ 08865-2773

Mailing address

185 Roseberry St
Farley BLDG., 2ND Floor
Phillipsburg, NJ 08865
Phone (908) 847-2621

Other names 1

  • St. Luke's Center for Urology Warren Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040323000967 NJ Part B Supplier - Clinic/Group Practice 9739093675 Receives reassigned benefits from 216 practitioners
13 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Phillipsburg, NJ; Washington, NJ; Hampton, NJ

Other NPIs on the same Medicare enrollment 13

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 13

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
31D2265409St Luke's Center for Urology - Warren755 Memorial Parkway, Phillipsburg, NJ 08865Certificate of waiverJul 26, 2026

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 25

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.

View all 25

NPI Registry JSON

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

{
    "created_epoch": "1649289600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1679011200000",
    "number": "1619618030",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "185 ROSEBERRY ST",
            "address_2": "FARLEY BLDG., 2ND FLOOR",
            "city": "PHILLIPSBURG",
            "state": "NJ",
            "postal_code": "08865",
            "telephone_number": "908-847-2621",
            "fax_number": "908-847-3045"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "755 MEMORIAL PKWY STE 207",
            "city": "PHILLIPSBURG",
            "state": "NJ",
            "postal_code": "088652773",
            "telephone_number": "484-526-2598",
            "fax_number": "866-522-4710"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST. LUKE'S WARREN PHYSICIAN GROUP, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-04-07",
        "last_updated": "2023-03-17",
        "certification_date": "2023-03-17",
        "status": "A",
        "authorized_official_last_name": "CHIAVAROLI",
        "authorized_official_first_name": "SUE",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "484-526-3569"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Urology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "St. Luke's Center for Urology Warren",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Phillipsburg, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.