NPIMap

Organization Active NPI

Neighborhood Health Centers of the Lehigh Valley

Doing business as NHCLV at Two Rivers H&W

  • Family Medicine Physician
  • Easton, PA
National Provider Identifier
1750821369
Registry record updated Jul 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
NEIGHBORHOOD HEALTH CENTERS OF THE LEHIGH VALLEY
Doing business as
NHCLV at Two Rivers H&W
Practice address
1101 Northampton St
Easton, PA 18042-4152
Phone
(610) 820-7605
Fax
(610) 820-7606
NPI assigned
Mar 1, 2017
Last updated
Jul 7, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 7, 2022

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

Authorized official

Name
Ms. Melissa Miranda, CEO
Title
Executive Director
Phone
(610) 820-7605

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X
Social Worker 104100000X PA
Clinical Social Worker 1041C0700X PA
Dentist 122300000X PA
Family Medicine Physician 207Q00000X PA Primary

Addresses

Primary practice location

1101 Northampton St
Easton, PA 18042-4152

Mailing address

635 E Broad St
Bethlehem, PA 18018-6332
Phone (610) 820-7605

Other identifiers 1

IdentifierTypeStateIssuer
PENDINGMedicaidPA

Other names 1

  • NHCLV at Two Rivers H&W Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20100526000092 PA Part B Supplier - Clinic/Group Practice 2961537352 Receives reassigned benefits from 54 practitioners
6 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Easton, PA; Bethlehem, PA; Allentown, PA
O20171018002519 PA Part A Provider - Federally Qualified Health Center (FQHC) 2961537352 Practice locations: Easton, PA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1750821369. Details of each certification follow.

Federally qualified health center certification: CCN 391100

Legal name
NEIGHBORHOOD HEALTH CENTERS OF THE LEHIGH VALLEY
Doing business as
NHCLV AT TWO RIVER H AND W
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Oct 18, 2017
Last certification
Oct 18, 2017
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Nov 5, 2004 in PA
Enrollment address
1101 Northampton St
Ste 202
Easton, PA 18042-4152

Other NPIs with the same Medicare PAC ID 5

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 6

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
39D2128173Nhclv - Two Rivers1101 Northampton St, Easton, PA 18042Provider-performed microscopyMar 26, 2027

National Provider Directory

National Provider Directory
Tax ID family
Nhclv at Broad Street7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

Organizations that report the same tax identification number in the National Provider Directory.

Ownership & related parties

All disclosed owners & managing parties 2

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Henery Aiken Individual Corporate OfficerPresident Jul 1, 2019
Melissa M Miranda Individual Corporate OfficerCeo Jul 30, 2013 100%
W-2 Managing EmployeeCeo/Executive Director Oct 18, 2017 100%

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Nhclv at Broad StreetBethlehem, PA, CCN 731900 Federally qualified health center Operational/Managerial Control Nov 19, 2004
Neighborhood Health Centers of the Lehigh Valley - Hamilton StreetAllentown, PA, CCN 731057 Federally qualified health center Operational/Managerial Control Nov 19, 2004

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Practitioners & affiliated clinicians

Practitioners 10

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.

NPI Registry JSON

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

{
    "created_epoch": "1488326400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1657152000000",
    "number": "1750821369",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "635 E BROAD ST",
            "city": "BETHLEHEM",
            "state": "PA",
            "postal_code": "180186332",
            "telephone_number": "610-820-7605",
            "fax_number": "610-820-7606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 NORTHAMPTON ST",
            "city": "EASTON",
            "state": "PA",
            "postal_code": "180424152",
            "telephone_number": "610-820-7605",
            "fax_number": "610-820-7606"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEIGHBORHOOD HEALTH CENTERS OF THE LEHIGH VALLEY",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-03-01",
        "last_updated": "2022-07-07",
        "certification_date": "2022-07-07",
        "status": "A",
        "authorized_official_last_name": "MIRANDA",
        "authorized_official_first_name": "MELISSA",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "610-820-7605",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "CEO"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "PA",
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "PA",
            "license": null,
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "PA",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PENDING",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "NHCLV at Two Rivers H&W",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "NHCLV at Two Rivers H&W",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Easton, PA

Sources for this page

Verify at the official NPI Registry.