Active NPI
St. Luke's Physician Group, Inc
- Family Medicine Physician
- Stroudsburg, PA
National Provider Identifier
1679972376
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- Legal business name
- ST. LUKE'S PHYSICIAN GROUP, INC
- Practice address
- 1581 N 9TH St
Stroudsburg, PA 18360-7576 - Phone
- (272) 212-4490
- NPI assigned
- Aug 19, 2014
- Last updated
- Jul 2, 2019
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Sue Chiavaroli
- Title
- Cvo Supervisor
- Phone
- (484) 526-3569
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | Primary |
Addresses
Primary practice location
1581 N 9TH St
Stroudsburg, PA 18360-7576
Mailing address
1803 W Main St
Stroudsburg, PA 18360-1027
Phone (570) 421-0170
Other practice location 1
1619 N 9th St Ste 1
Stroudsburg, PA 18360-6501
Phone (570) 664-8900
Other practice location 2
1803 W Main St
Stroudsburg, PA 18360-1027
Phone (570) 421-0170
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in PA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040226000062 | PA | Part B Supplier - Clinic/Group Practice | 6709798333 |
Receives reassigned benefits from 3,523 practitioners This NPI is an additional NPI on the enrollment |
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
Practitioners 3
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
-
- Family Medicine Physician
- Fogelsville, PA
- NPI 1336286004
-
- Family Medicine Physician
- Wind Gap, PA
- NPI 1154067916
-
- Family Medicine Physician
- Stroudsburg, PA
- NPI 1992457204
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1408406400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1562025600000",
"number": "1679972376",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1803 W MAIN ST",
"city": "STROUDSBURG",
"state": "PA",
"postal_code": "183601027",
"telephone_number": "570-421-0170",
"fax_number": "570-424-5167"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1581 N 9TH ST",
"city": "STROUDSBURG",
"state": "PA",
"postal_code": "183607576",
"telephone_number": "272-212-4490"
}
],
"practiceLocations": [
{
"address_1": "1619 N 9th St Ste 1",
"address_purpose": "LOCATION",
"city": "Stroudsburg",
"state": "PA",
"postal_code": "183606501",
"country_code": "US",
"telephone_number": "570-664-8900",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1803 W Main St",
"address_purpose": "LOCATION",
"city": "Stroudsburg",
"state": "PA",
"postal_code": "183601027",
"country_code": "US",
"telephone_number": "570-421-0170",
"fax_number": "570-424-5167",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"organization_name": "ST. LUKE'S PHYSICIAN GROUP, INC",
"organizational_subpart": "NO",
"enumeration_date": "2014-08-19",
"last_updated": "2019-07-02",
"status": "A",
"authorized_official_last_name": "CHIAVAROLI",
"authorized_official_first_name": "SUE",
"authorized_official_title_or_position": "CVO SUPERVISOR",
"authorized_official_telephone_number": "484-526-3569"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Family Medicine",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Stroudsburg, PA
- St Luke's Physician Group, Inc (St. Luke's Internal Medicine Lifeline Road)
- St. Luke's Homestar Services, LLC (St. Luke's Homestar Pharmacy)
- St. Luke's Hospital Monroe Campus
- St. Luke's Hospital Monroe Campus
- St. Luke's Physician Group, Inc (St. Luke's Nephrology Associates of Monroe County)
- St. Luke's Physician Group, Inc
- St. Luke's Physician Group, Inc. (St. Luke's Stroudsburg Internal Medicine)
- Leah Stahler, PA-C
- Robert J Starner, DDS
- Lubomira Stieber
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.