Organization Active NPI

Pain Specialists of Greater Lehigh Valley, P.C.

  • Pain Medicine Physician
  • Allentown, PA
National Provider Identifier
1679560403
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine PhysicianTaxonomy code 208VP0000X
Legal business name
PAIN SPECIALISTS OF GREATER LEHIGH VALLEY, P.C.
Practice address
1240 S Cedar Crest Blvd
Suite #307
Allentown, PA 18103-6369
Phone
(610) 402-1757
Fax
(610) 402-9089
NPI assigned
Oct 6, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Loretta Kowalick
Title
Practice Administrator
Phone
(610) 402-1757

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208VP0000X PA Primary
Pain Clinic/Center 261QP3300X PA
Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363L00000X PA

Addresses

Primary practice location

1240 S Cedar Crest Blvd
Suite #307
Allentown, PA 18103-6369

Mailing address

1245 S Cedar Crest Blvd
Suite #301
Allentown, PA 18103-6258
Phone (610) 402-1757

Other identifiers 9

IdentifierTypeStateIssuer
1316068OtherPAHIGHMARK
0018828370001MedicaidPA
30000050OtherPAKEYSTONE MERCY
02009185000OtherPAIBC
03158300OtherPACAPITAL BLUE CROSS
1316068OtherPAKHP CENTRAL
1522741OtherPAGATEWAY
20012177OtherPWAMERIHEALTH MERCY
2608852OtherPAAETNA

National Provider Directory

National Provider Directory

Locations

1240 S Cedar Crest Blvd
Ste 307
Allentown, PA 18103
Phone (610) 402-1757

501 Saint John St
Allentown, PA 18103
Phone (610) 776-3262

1245 S Cedar Crest Blvd
Ste 310
Allentown, PA 18103

1150 Glenlivet Dr
Ste C36
Allentown, PA 18106

2855 Schoenersville Rd
Fl 1
Bethlehem, PA 18017

2545 Schoenersville Rd
#3
Bethlehem, PA 18017

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1128556800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1679560403",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1245 S CEDAR CREST BLVD",
            "address_2": "SUITE #301",
            "city": "ALLENTOWN",
            "state": "PA",
            "postal_code": "181036258",
            "telephone_number": "610-402-1757",
            "fax_number": "610-402-9089"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1240 S CEDAR CREST BLVD",
            "address_2": "SUITE #307",
            "city": "ALLENTOWN",
            "state": "PA",
            "postal_code": "181036369",
            "telephone_number": "610-402-1757",
            "fax_number": "610-402-9089"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAIN SPECIALISTS OF GREATER LEHIGH VALLEY, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-06",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "KOWALICK",
        "authorized_official_first_name": "LORETTA",
        "authorized_official_title_or_position": "PRACTICE ADMINISTRATOR",
        "authorized_official_telephone_number": "610-402-1757"
    },
    "taxonomies": [
        {
            "code": "208VP0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pain Medicine, Pain Medicine",
            "state": "PA",
            "license": null,
            "primary": true
        },
        {
            "code": "261QP3300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Pain",
            "state": "PA",
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": "PA",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIGHMARK",
            "identifier": "1316068",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0018828370001",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KEYSTONE MERCY",
            "identifier": "30000050",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IBC",
            "identifier": "02009185000",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAPITAL BLUE CROSS",
            "identifier": "03158300",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KHP CENTRAL",
            "identifier": "1316068",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GATEWAY",
            "identifier": "1522741",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIHEALTH MERCY",
            "identifier": "20012177",
            "state": "PW"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "2608852",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Allentown, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.