St. Luke'S Physician Group Inc
Organization Active NPI Family Medicine Physician · Easton, PA
NPI 1750918652 · NPPES record last updated Mar 27, 2020
Key facts
- NPI
- 1750918652
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Family Medicine Physician 207Q00000X
- Legal business name
- ST. LUKE'S PHYSICIAN GROUP INC
- Practice address
- 2461 Nazareth Rd
Easton, PA 18045-2743 - Phone
- (610) 258-5300
- NPI assigned
- Mar 23, 2020
- Organization subpart
- No
Authorized official
- Name
- Sue Chiavaroli
- Title
- Cvo Supervisor
- Phone
- (484) 526-3569
Corporate family (same tax ID) 24
Practitioners 1
-
Todd Michael Zoltack, PA-C
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in PA
Medicare enrollment records
| 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
- Tax ID family
- Upper Bucks Emergency M
Locations
2461 Nazareth Rd
Easton, PA 18045
Phone (610) 252-1020
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician |
207Q00000X | Yes |
Addresses
Primary practice location
2461 Nazareth Rd
Easton, PA 18045-2743
Mailing address
801 Ostrum St
Bethlehem, PA 18015-1000
Phone (484) 526-4000
Other names
- St. Luke's Family Medicine- 25th Street
Other providers in Easton, PA
- St. Luke'S Physician Group Inc
- St. Luke'S Physician Group Inc
- St. Luke'S Physician Group Inc
- St. Luke'S Physician Group Inc
- St. Luke'S Physician Group Inc
- St. Luke'S Physician Group Inc.
- St. Luke'S Physician Group Inc.
- St. Luke'S Physician Group Inc.
- St. Luke'S Physician Group Inc., Dba
- St. Luke'S Physician Group, Inc
All providers in Easton, PA · Family Medicine Physician in Pennsylvania
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 27, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.