NPIMap

Individual provider Active NPI

Patricia Anne Koba, CRNP

  • Nurse Practitioner
  • Bethlehem, PA
National Provider Identifier
1699146662
Registry record updated Oct 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
SP015571 Issued in PA
Practice address
81 Highland Ave Ste 220
Bethlehem, PA 18017-9310
Phone
(610) 868-1100
NPI assigned
Oct 15, 2015
Last updated
Oct 8, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 8, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X SP015571 PA Primary

Addresses

Primary practice location

81 Highland Ave Ste 220
Bethlehem, PA 18017-9310

Mailing address

1417 8TH Ave
Bethlehem, PA 18018-2256
Phone (484) 526-5210

Other practice location 1

1417 8th Ave
Bethlehem, PA 18018-2256
Phone (484) 526-5210

Other practice location 2

801 Ostrum St
Bethlehem, PA 18015-1000
Phone (866) 785-8537

Other names 1

  • Patricia Anne Bresnak Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, NJ2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20151209002609 PA Practitioner - Nurse Practitioner 9830490218 Reassigns benefits to 4 organizations
I20260429003664 NJ Practitioner - Nurse Practitioner 9830490218 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Lukes Physician Group IncGroup PAC ID 6709798333, 2,161 clinicians

Practice addresses (Care Compare)

1417 8TH Ave
St Luke's Neurology Associates
Bethlehem, PA 18018-0000
Phone (484) 526-5210

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
97.13 of 100Reported as apm
Quality
82.27
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
University of Penn - Medical Group CurrentSince Dec 21, 2015 Accepting new patients
Gslpg, Inc CurrentSince Nov 4, 2019 Accepting new patients
University of Penn - Medical Group CurrentSince Jan 18, 2017 Accepting new patients
St. Luke's Physician Group, Inc. Current Accepting new patients
St Luke's Physician Group Inc CurrentSince Dec 18, 2017 Accepting new patients
St. Luke's Physician Group, Inc. CurrentSince Dec 18, 2017 Accepting new patients
University of Penn-Medical Group CurrentSince Dec 21, 2015 Accepting new patients
St. Luke's Physician Group, Inc. Past Accepting new patients

Locations

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

100 Paramount Blvd
Orwigsburg, PA 17961
Phone (272) 639-1000

3400 Spruce St
Fl 3
Philadelphia, PA 19104

3624 Market St
Fl 2
Philadelphia, PA 19104
Phone (215) 615-3669

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 7

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": "1444867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728345600000",
    "number": "1699146662",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1417 8TH AVE",
            "city": "BETHLEHEM",
            "state": "PA",
            "postal_code": "180182256",
            "telephone_number": "484-526-5210",
            "fax_number": "484-526-5237"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "81 HIGHLAND AVE STE 220",
            "city": "BETHLEHEM",
            "state": "PA",
            "postal_code": "180179310",
            "telephone_number": "610-868-1100"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1417 8th Ave",
            "address_purpose": "LOCATION",
            "city": "Bethlehem",
            "state": "PA",
            "postal_code": "180182256",
            "country_code": "US",
            "telephone_number": "484-526-5210",
            "fax_number": "484-526-5237",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "801 Ostrum St",
            "address_purpose": "LOCATION",
            "city": "Bethlehem",
            "state": "PA",
            "postal_code": "180151000",
            "country_code": "US",
            "telephone_number": "866-785-8537",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KOBA",
        "first_name": "PATRICIA",
        "middle_name": "ANNE",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-10-15",
        "last_updated": "2024-10-08",
        "certification_date": "2024-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "PA",
            "license": "SP015571",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "PATRICIA",
            "last_name": "BRESNAK",
            "middle_name": "ANNE",
            "credential": "CRNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Bethlehem, PA

Sources for this page

Verify at the official NPI Registry.