NPIMap

Individual provider Active NPI

Mykel Gamil Tadros, DO

  • Nephrology Physician
  • Allentown, PA
National Provider Identifier
1629567128
Registry record updated Dec 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
OS022445 Issued in PA
Practice address
1230 S Cedar Crest Blvd Ste 302304
Allentown, PA 18103-6367
Phone
(610) 432-4529
NPI assigned
May 9, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 5, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X OS022445 PA Primary

Addresses

Primary practice location

1230 S Cedar Crest Blvd Ste 302304
Allentown, PA 18103-6367

Mailing address

1230 S Cedar Crest Blvd Ste 302304
Allentown, PA 18103-6367
Phone (610) 432-4529

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
I20230605002282 PA Practitioner - Nephrology 1355752932 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nephrology
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Valley Kidney Specialists, P.C.Group PAC ID 2860670734, 31 clinicians

Practice addresses (Care Compare)

1230 S Cedar Crest Blvd
Allentown, PA 18103-6212
Phone (610) 432-4529

2014 City Line Rd
Suite 103
Bethlehem, PA 18017-2190
Phone (610) 432-4529

45 Constitution Blvd
Kutztown, PA 19530-1737
Phone (610) 432-4529

Hospital & facility affiliations

  • Lehigh Valley Hospital Hospital, Allentown, PA, CCN 390133
  • St Lukes Hospital Hospital, Bethlehem, PA, CCN 390049
  • Lehigh Valley Hospital Inpatient rehabilitation facility, Allentown, PA, CCN 39T133

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Valley Kidney Specialists, PC Nephrology CurrentSince Apr 20, 2025 Accepting new patients
Kidney Care Specialists LLC Nephrology CurrentSince Jun 22, 2023 Accepting new patients
Valley Kidney Specialists, P.C. Nephrology CurrentSince Apr 20, 2025 Accepting new patients

Locations

1230 S Cedar Crest Blvd
Ste 301
Allentown, PA 18103
Phone (610) 432-4873

1230 S Cedar Crest Blvd
Ste 302304
Allentown, PA 18103
Phone (610) 402-2537

1230 S Cedar Crest Blvd
Ste 304
Allentown, PA 18103
Phone (452) 961-0432

1230 S Cedar Crest Blvd
Ste 302
Allentown, PA 18103
Phone (610) 770-0616

1200 S Cedar Crest Blvd
Allentown, PA 18103
Phone (484) 862-3200

2000 Sproul Rd
Ste 300
Broomall, PA 19008
Phone (610) 356-3700

45 Constitution Blvd
Kutztown, PA 19530
Phone (610) 683-7349

1105 Bethlehem Pike
#B5
Sellersville, PA 18960
Phone (215) 257-4533

Interoperability endpoints

  • Direct secure messaging: mtadros32189@direct.acumenmd.com

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 12

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": "1525824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701734400000",
    "number": "1629567128",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1230 S CEDAR CREST BLVD STE 302304",
            "city": "ALLENTOWN",
            "state": "PA",
            "postal_code": "181036367",
            "telephone_number": "610-432-4529"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1230 S CEDAR CREST BLVD STE 302304",
            "city": "ALLENTOWN",
            "state": "PA",
            "postal_code": "181036367",
            "telephone_number": "610-432-4529"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TADROS",
        "first_name": "MYKEL",
        "middle_name": "GAMIL",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-05-09",
        "last_updated": "2023-12-05",
        "certification_date": "2023-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "PA",
            "license": "OS022445",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Allentown, PA

Sources for this page

Verify at the official NPI Registry.