Individual provider Active NPI

Patrick Niebauer, PH.D.

  • Clinical Social Worker
  • Sellersville, PA
National Provider Identifier
1639428816
Registry record updated Sep 5, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
CW012072 Issued in PA
Practice address
807 Lawn Ave
Sellersville, PA 18960-1549
Phone
(215) 257-6551
Fax
(215) 257-9347
NPI assigned
Sep 5, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 5, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X CW012072 PA Primary

Addresses

Primary practice location

807 Lawn Ave
Sellersville, PA 18960-1549

Mailing address

601 South Main Street
Coopersburg, PA 18036
Phone (484) 863-4632

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20121106000469 PA Practitioner - Clinical Social Worker 4183875818 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1988
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)

257 Brodhead Rd
Bethlehem, PA 18017-8938
Phone (484) 526-2400

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
St. Luke'S Physician Group, Inc. Current Accepting new patients
St. Luke'S Physician Group, Inc. CurrentSince Feb 17, 2025 Accepting new patients
St Luke'S Physician Group Inc CurrentSince Feb 17, 2025 Accepting new patients
Wings of Change Counseling, LLC Past Accepting new patients
Merakey Pennsylvania Past Accepting new patients

Locations

257 Brodhead Rd
Bethlehem, PA 18017
Phone (484) 503-3057

21 N Main St
Ste 9
Coopersburg, PA 18036
Phone (267) 214-9678

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

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1346803200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1346803200000",
    "number": "1639428816",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 SOUTH MAIN STREET",
            "city": "COOPERSBURG",
            "state": "PA",
            "postal_code": "18036",
            "telephone_number": "484-863-4632"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "807 LAWN AVE",
            "city": "SELLERSVILLE",
            "state": "PA",
            "postal_code": "189601549",
            "telephone_number": "215-257-6551",
            "fax_number": "215-257-9347"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NIEBAUER",
        "first_name": "PATRICK",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-09-05",
        "last_updated": "2012-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "PA",
            "license": "CW012072",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sellersville, PA

Sources for this page

Verify at the official NPI Registry.