Individual provider Active NPI

Bryan W Kluck, D.O.

  • Cardiovascular Disease Physician
  • Allentown, PA
National Provider Identifier
1659486959
Registry record updated Nov 23, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
OS005012L Issued in PA
Practice address
1250 S Cedar Crest Blvd
Suite 300
Allentown, PA 18103-6224
Phone
(610) 402-3110
NPI assigned
Aug 20, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 23, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X OS005012L PA Primary

Addresses

Primary practice location

1250 S Cedar Crest Blvd
Suite 300
Allentown, PA 18103-6224

Mailing address

PO Box 783311
Philadelphia, PA 19178-3311

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: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090116000324 PA Practitioner - Cardiovascular Disease (Cardiology) 9739269796 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
Philadelphia College of Osteopathic Medicine, 1981
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Advanced Limb Salvage Center LLCGroup PAC ID 5193127686, 3 clinicians

Practice addresses (Care Compare)

3040 Market St
Camp Hill, PA 17011-4539
Phone (717) 727-0480

Procedures performed for Medicare patients

ProcedureNumber of procedures
Varicose vein removal28

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Cardiovascular Experts, LLC CurrentSince Apr 3, 2023 Accepting new patients
Advanced Limb Salvage Center LLC Cardiovascular Disease CurrentSince Apr 3, 2023 Accepting new patients
Cardiovascular Experts of Pennsylvania, LLC CurrentSince Apr 3, 2023 Accepting new patients
Pulmonary Associates PC Past Accepting new patients
Lehigh Valley Physician Group Past Accepting new patients

Locations

3040 Market St
Camp Hill, PA 17011
Phone (717) 727-0480

3040 Market St
#1
Camp Hill, PA 17011

Interoperability endpoints

  • Direct secure messaging: bryankluckdo@cardiovascularexperts.medentdirect.com
  • Direct secure messaging: bryankluck@alsc.medentdirect.com

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": "1156032000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1448236800000",
    "number": "1659486959",
    "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": "1250 S CEDAR CREST BLVD",
            "address_2": "SUITE 300",
            "city": "ALLENTOWN",
            "state": "PA",
            "postal_code": "181036224",
            "telephone_number": "610-402-3110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLUCK",
        "first_name": "BRYAN",
        "middle_name": "W",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-20",
        "last_updated": "2015-11-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "PA",
            "license": "OS005012L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Allentown, PA

Sources for this page

Verify at the official NPI Registry.