Individual provider Active NPI

Nicholas C Latham

  • Physician Assistant
  • Bethlehem, PA
National Provider Identifier
1639700958
Registry record updated Jan 21, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
MA061421 Issued in PA
Practice address
801 Ostrum St
Bethlehem, PA 18015-1000
Phone
(484) 526-4500
Fax
(484) 526-6674
NPI assigned
Jan 27, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 21, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 035036 NY
Physician Assistant 363A00000X MA061421 PA Primary

Addresses

Primary practice location

801 Ostrum St
Bethlehem, PA 18015-1000

Mailing address

801 Ostrum St
Bethlehem, PA 18015-1000
Phone (484) 526-4500

Other practice location 1

1201 Langhorne Newtown Rd
Langhorne, PA 19047-1201
Phone (215) 710-2100

Other identifiers 1

IdentifierTypeStateIssuer
0819751MedicaidNJ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, NY, NJ3 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20200610001691 PA Practitioner - Physician Assistant 5698196012 Reassigns benefits to 3 organizations
I20260130000587 NY Practitioner - Physician Assistant 5698196012 Reassigns benefits to 2 organizations
I20260610004619 NJ Practitioner - Physician Assistant 5698196012

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Emergency Physician Services of New York, P.C.Group PAC ID 8325939804, 128 clinicians

Practice addresses (Care Compare)

111 Hospital Dr
Utica, NY 13502-2517
Phone (315) 917-9966

175 Madison Ave
Mount Holly, NJ 08060-2038
Phone (609) 267-0700

32 Central Ave
Wellsboro, PA 16901-1899
Phone (570) 723-7764

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
035036NYMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Physician Services of New York, P.C. Physician Assistant CurrentSince Mar 1, 2026 Accepting new patients
Buffalo Emergency Associates LLP CurrentSince Mar 1, 2026 Accepting new patients
St. Luke's Physician Group, Inc. CurrentSince Mar 2, 2020 Accepting new patients
St Luke's Physician Group Inc CurrentSince Mar 2, 2020 Accepting new patients
Emergency Care Services of Pennsylvania, P.C. Physician Assistant CurrentSince Oct 1, 2021 Accepting new patients

Locations

565 Abbott Rd
Buffalo, NY 14220
Phone (716) 826-7000

2605 Harlem Rd
Cheektowaga, NY 14225
Phone (716) 891-2315

2209 Genesee St
Utica, NY 13501
Phone (315) 798-8100

111 Hospital Dr
Utica, NY 13502
Phone (315) 801-8534

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

1201 Langhorne Newtown Rd
Penndel, PA 19047
Phone (215) 710-2100

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 1

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": "1580083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1768953600000",
    "number": "1639700958",
    "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": "484-526-4500",
            "fax_number": "484-526-6674"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 OSTRUM ST",
            "city": "BETHLEHEM",
            "state": "PA",
            "postal_code": "180151000",
            "telephone_number": "484-526-4500",
            "fax_number": "484-526-6674"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1201 Langhorne Newtown Rd",
            "address_purpose": "LOCATION",
            "city": "Langhorne",
            "state": "PA",
            "postal_code": "190471201",
            "country_code": "US",
            "telephone_number": "215-710-2100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LATHAM",
        "first_name": "NICHOLAS",
        "middle_name": "C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-01-27",
        "last_updated": "2026-01-21",
        "certification_date": "2026-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "035036",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA061421",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0819751",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bethlehem, PA

Sources for this page

Verify at the official NPI Registry.