NPIMap

Individual provider Active NPI

Charles L Ludivico, MD

  • Rheumatology Physician
  • Fountain Hill, PA
National Provider Identifier
1750439147
Registry record updated Jun 20, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rheumatology PhysicianTaxonomy code 207RR0500X
License
MD012628E Issued in PA
Practice address
701 Ostrum St Ste 302
Fountain Hill, PA 18015-1152
Phone
(610) 868-1336
Fax
(610) 332-2436
NPI assigned
Jan 8, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 20, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rheumatology Physician 207RR0500X MD012628E PA Primary

Addresses

Primary practice location

701 Ostrum St Ste 302
Fountain Hill, PA 18015-1152

Mailing address

701 Ostrum St
Ste 402
Bethlehem, PA 18015
Phone (610) 868-1336

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120220000998 PA Practitioner - Rheumatology 0446202295 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Rheumatology
Education
Temple University School of Medicine, 1973
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

701 Ostrum St
Suite 302
Fountain Hill, PA 18015-1152
Phone (610) 868-1336

Hospital & facility affiliations

  • St Lukes Hospital Hospital, Bethlehem, PA, CCN 390049
  • St Luke'S Hospital - Monroe Campus Hospital, Stroudsburg, PA, CCN 390330
  • Lehigh Valley Hospital - Pocono Hospital, East Stroudsburg, PA, CCN 390201
  • Lehigh Valley Hospital Hospital, Allentown, PA, CCN 390133
  • St Luke'S Hospital - Upper Bucks Campus Hospital, Quakertown, PA, CCN 390035

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
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Star Community Health, Inc CurrentSince Mar 2, 2019 Accepting new patients
East Penn Rheumatology Associates, P.C. Rheumatology CurrentSince Mar 1, 1990 Accepting new patients
Star Community Health, Inc CurrentSince Mar 2, 2019 Accepting new patients
East Penn Rheumatology Rheumatology Current Accepting new patients
Christmas City Obstetrics and Gynecology Associates Inc Past Accepting new patients

Locations

511 E 3rd St
Ste 301
Bethlehem, PA 18015
Phone (484) 526-2460

511 E 3rd St
Ste 200
Bethlehem, PA 18015
Phone (484) 526-4700

701 Ostrum St
Ste 402
Fountain Hill, PA 18015
Phone (610) 867-6161

701 Ostrum St
Ste 501
Fountain Hill, PA 18015
Phone (484) 526-6161

701 Ostrum St
Ste 302
Fountain Hill, PA 18015
Phone (484) 526-6000

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

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.

Hospital & facility affiliations 14

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1168214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560988800000",
    "number": "1750439147",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "701 OSTRUM ST",
            "address_2": "STE 402",
            "city": "BETHLEHEM",
            "state": "PA",
            "postal_code": "18015",
            "telephone_number": "610-868-1336",
            "fax_number": "610-332-2436"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 OSTRUM ST STE 302",
            "city": "FOUNTAIN HILL",
            "state": "PA",
            "postal_code": "180151152",
            "telephone_number": "610-868-1336",
            "fax_number": "610-332-2436"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUDIVICO",
        "first_name": "CHARLES",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-08",
        "last_updated": "2019-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RR0500X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Rheumatology",
            "state": "PA",
            "license": "MD012628E",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fountain Hill, PA

Sources for this page

Verify at the official NPI Registry.