NPIMap

Individual provider Active NPI

Kristin A Tyson, PA

  • Medical Physician Assistant
  • Allentown, PA
National Provider Identifier
1639440548
Registry record updated Dec 23, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
MA055148 Issued in PA
Practice address
1611 Pond Rd
Ste 401
Allentown, PA 18104-2258
Phone
(610) 398-7700
Fax
(610) 398-6917
NPI assigned
Jan 24, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 23, 2015

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 MA055148 PA Primary

Addresses

Primary practice location

1611 Pond Rd
Ste 401
Allentown, PA 18104-2258

Mailing address

PO Box 783311
Philadelphia, PA 19178-3311

Other names 1

  • Kristin A Liew Former name

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
I20120208000145 PA Practitioner - Physician Assistant 3577720234 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2011
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

1611 Pond Rd
Allentown, PA 18104-2258

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MA055148PAMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Lehigh Valley Physician Group CurrentSince Jun 1, 2017 Accepting new patients
Schuylkill Health System Medical Group, Inc. CurrentSince Apr 17, 2024 Accepting new patients
Lehigh Valley Physician Group CurrentSince Jun 1, 2017 Accepting new patients
Lehigh Valley Physician Group Past Accepting new patients
Pulmonary Associates PC Past Accepting new patients

Locations

2100 Mack Blvd
Fl 4
Allentown, PA 18103

1611 Pond Rd
Ste 401
Allentown, PA 18104
Phone (610) 398-7700

206 E Brown St
East Stroudsburg, PA 18301
Phone (570) 420-4951

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

700 Schuylkill Manor Rd
Ste 3
Pottsville, PA 17901
Phone (570) 621-4440

171 Red Horse Rd
Pottsville, PA 17901
Phone (570) 628-2229

6 S Greenview Rd
Schuylkill Haven, PA 17972
Phone (570) 366-3915

600 Commerce Blvd
Stroudsburg, PA 18360
Phone (570) 424-7390

224 Claremont Ave
Tamaqua, PA 18252
Phone (570) 628-2229

Interoperability endpoints

  • Direct secure messaging: ktyson11977@direct2.lvhn.org

Organizations & group practices 9

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 11

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": "1327363200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1450828800000",
    "number": "1639440548",
    "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": "1611 POND RD",
            "address_2": "STE 401",
            "city": "ALLENTOWN",
            "state": "PA",
            "postal_code": "181042258",
            "telephone_number": "610-398-7700",
            "fax_number": "610-398-6917"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TYSON",
        "first_name": "KRISTIN",
        "middle_name": "A",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-01-24",
        "last_updated": "2015-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "PA",
            "license": "MA055148",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KRISTIN",
            "last_name": "LIEW",
            "middle_name": "A",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Allentown, PA

Sources for this page

Verify at the official NPI Registry.