Individual provider Active NPI

Amanda Marie Pena

  • Obstetrics & Gynecology Physician
  • Allentown, PA
National Provider Identifier
1770112104
Registry record updated Jul 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
MD0485625 Issued in PA
Practice address
1245 S Cedar Crest Blvd Ste 201
Allentown, PA 18103-6258
Phone
(610) 402-4870
NPI assigned
Apr 7, 2020
Last updated
Jul 11, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 11, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X MD0485625 PA Primary

Addresses

Primary practice location

1245 S Cedar Crest Blvd Ste 201
Allentown, PA 18103-6258

Mailing address

5 Richlee CT Apt 1S
Mineola, NY 11501-3625
Phone (718) 749-3498

Other practice location 1

550 1st Ave
New York, NY 10016-6402
Phone (212) 263-5506

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20240724000144 PA Practitioner - Obstetrics/Gynecology 4587100730 Reassigns benefits to 3 organizations
I20241230001785 NJ Practitioner - Obstetrics/Gynecology 4587100730 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
State University of New York at Stony Brook, School of Medicine, 2020
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)

185 Roseberry St
Phillipsburg, NJ 08865-1690
Phone (484) 526-4789

185 Roseberry St
Farley BLDG. 2ND Floor
Phillipsburg, NJ 08865-1627

1872 St Lukes Blvd
Easton, PA 18045-5669
Phone (484) 526-7800

2403 Butler St
Easton, PA 18042-5302
Phone (484) 526-7474

306 S New St
Bethlehem, PA 18015-1652

306 S New Street
Bethlehem, PA 18015-1652

39 Roseberry St
Suite 2
Phillipsburg, NJ 08865-1627
Phone (908) 847-1037

4051 Freemansburg Ave
Easton, PA 18045-5596
Phone (484) 503-7474

6689 Sullivan TRL
Wind Gap, PA 18091-9790
Phone (610) 954-4960

6695 Sullivan TRL
Suite 201
Wind Gap, PA 18091-9790
Phone (610) 691-3131

755 Memorial Pkwy
Phillipsburg, NJ 08865-2771

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD0485625PAMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St. Luke's Physician Group, Inc. CurrentSince Sep 5, 2024 Accepting new patients
Star Community Health, Inc Current Accepting new patients
Lehigh Valley Physician Group CurrentSince Jul 11, 2024 Accepting new patients
Lehigh Valley Physician Group Obstetrics & Gynecology Current Accepting new patients
St. Luke's Warren Physician Group, PC CurrentSince Dec 1, 2024 Accepting new patients
St. Luke's Warren Physician Group, PC CurrentSince Dec 1, 2024 Accepting new patients
St. Luke's Warren Physician Group, PC Current Accepting new patients
St. Luke's Physician Group, Inc. Current Accepting new patients
St Luke's Physician Group Inc CurrentSince Sep 5, 2024 Accepting new patients
Lehigh Valley Physician Group CurrentSince Jul 11, 2024 Accepting new patients
Star Community Health, Inc CurrentSince Sep 5, 2024 Accepting new patients
St Luke's Hospital Past Accepting new patients
St Lukes Hospital-Anderson Campus Past Accepting new patients

Locations

185 Roseberry St
Bldg 2ND
Phillipsburg, NJ 08865
Phone (908) 847-2619

755 Memorial Pkwy
Ste 302
Phillipsburg, NJ 08865
Phone (908) 847-6722

1245 S Cedar Crest Blvd
Ste 201
Allentown, PA 18103
Phone (610) 402-4870

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

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

Interoperability endpoints

  • Direct secure messaging: apena327134@direct-sluhn.org

Organizations & group practices 14

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.

View all 14

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": "1586217600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720656000000",
    "number": "1770112104",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 RICHLEE CT APT 1S",
            "city": "MINEOLA",
            "state": "NY",
            "postal_code": "115013625",
            "telephone_number": "718-749-3498"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1245 S CEDAR CREST BLVD STE 201",
            "city": "ALLENTOWN",
            "state": "PA",
            "postal_code": "181036258",
            "telephone_number": "610-402-4870"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "550 1st Ave",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100166402",
            "country_code": "US",
            "telephone_number": "212-263-5506",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PENA",
        "first_name": "AMANDA",
        "middle_name": "MARIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-04-07",
        "last_updated": "2024-07-11",
        "certification_date": "2024-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "PA",
            "license": "MD0485625",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Allentown, PA

Sources for this page

Verify at the official NPI Registry.