Individual provider Active NPI

Brandon McIntosh, PAC

  • Physician Assistant
  • Allentown, PA
National Provider Identifier
1710704614
Registry record updated Sep 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
MA066025 Issued in PA
Practice address
1736 Hamilton St
Allentown, PA 18104-5656
Phone
(610) 628-8383
NPI assigned
Sep 23, 2024
Last updated
Sep 23, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 23, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X MA066025 PA Primary

Addresses

Primary practice location

1736 Hamilton St
Allentown, PA 18104-5656

Mailing address

1736 Hamilton St
Allentown, PA 18104-5656

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240926003117 PA Practitioner - Physician Assistant 9234660523 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2024
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)

801 Ostrm St
Bethlehem, PA 18015-1000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MA066025PAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
St Luke's Physician Group Inc CurrentSince Oct 28, 2024 Accepting new patients
St Luke's Physician Group Inc CurrentSince Oct 28, 2024 Accepting new patients

Locations

1736 Hamilton St
Allentown, PA 18104
Phone (610) 770-8300

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

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

Interoperability endpoints

  • Direct secure messaging: bmcintosh305752@direct-sluhn.org

Organizations & group practices 4

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 6

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": "1727049600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727049600000",
    "number": "1710704614",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1736 HAMILTON ST",
            "city": "ALLENTOWN",
            "state": "PA",
            "postal_code": "181045656"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1736 HAMILTON ST",
            "city": "ALLENTOWN",
            "state": "PA",
            "postal_code": "181045656",
            "telephone_number": "610-628-8383"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCINTOSH",
        "first_name": "BRANDON",
        "credential": "PAC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-09-23",
        "last_updated": "2024-09-23",
        "certification_date": "2024-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA066025",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Allentown, PA

Sources for this page

Verify at the official NPI Registry.