Individual provider Active NPI

Jacob Tyler Stancato

  • Medical Physician Assistant
  • Allentown, PA
National Provider Identifier
1770245367
Registry record updated Mar 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
MA063010 Issued in PA
Practice address
1200 S Cedar Crest Blvd
Allentown, PA 18103-6202
Phone
(610) 402-8000
NPI assigned
Oct 11, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 15, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X MA063010 PA Primary

Addresses

Primary practice location

1200 S Cedar Crest Blvd
Allentown, PA 18103-6202

Mailing address

2100 Mack Blvd FL 4
Allentown, PA 18103-5622
Phone (484) 629-2282

Other practice location 1

2545 Schoenersville Rd
Bethlehem, PA 18017-7300
Phone (610) 402-8000

Other identifiers 1

IdentifierTypeStateIssuer
MA063010OtherPASTATE LICENSE

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
I20220125003080 PA Practitioner - Physician Assistant 5698167609 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lehigh Valley Physician GroupGroup PAC ID 3072425123, 2,512 clinicians
Phoenix Rehabilitation and Health Services IncGroup PAC ID 3476464298, shared by 2 NPIs, 2,775 clinicians

Practice addresses (Care Compare)

1200 S Cedar Crest Blvd
Allentown, PA 18103-6202

1200 S Cedar Crest Blvd 3Rd FL Kasych
LVPG Burn Surgery
Allentown, PA 18103-6202
Phone (610) 402-8355

1200 S Cedar Crest Blvd FL
1 LVPG Nephrology
Allentown, PA 18103-6202
Phone (610) 402-8510

1210 S Cedar Crest Blvd
Allentown, PA 18103-6235
Phone (610) 402-3888

1250 S Cedar Crest Blvd
Allentown, PA 18103-6224

1503 N Cedar Crest Blvd
LVH Hospitalist PGRM
Allentown, PA 18104-2310
Phone (610) 861-8080

2000 Westinghouse Dr
Suite 200
Cranberry Township, PA 16066-5238

2300 Highland Ave
Bethlehem, PA 18020-8920
Phone (610) 402-6164

2310 Highland Ave
Bethlehem, PA 18020-8920
Phone (610) 691-6248

2545 Schoenersville Rd
Bethlehem, PA 18017-7300

5649 Wynnewood Dr
Laurys Station, PA 18059-1124

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MA063010PAMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Lehigh Valley Physician Group CurrentSince Jan 10, 2022 Accepting new patients
Lehigh Valley Physician Group CurrentSince Jan 10, 2022 Accepting new patients
Hazleton Professional Services CurrentSince Jul 21, 2022 Accepting new patients
Pulmonary Associates PC Past Accepting new patients

Locations

2100 Mack Blvd
Fl 4
Allentown, PA 18103

1200 S Cedar Crest Blvd
Allentown, PA 18103
Phone (484) 862-3200

2545 Schoenersville Rd
Bethlehem, PA 18017
Phone (484) 884-2888

1000 Alliance Dr
#10
Hazleton, PA 18202
Phone (570) 501-6450

5649 Wynnewood Dr
Ste 104
Laurys Station, PA 18059
Phone (610) 262-6641

320 W Pumping Station Rd
Quakertown, PA 18951
Phone (215) 529-4240

Interoperability endpoints

  • Direct secure messaging: jstancato619861@direct2.lvhn.org

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 5

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": "1633910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647302400000",
    "number": "1770245367",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 MACK BLVD FL 4",
            "city": "ALLENTOWN",
            "state": "PA",
            "postal_code": "181035622",
            "telephone_number": "484-629-2282"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 S CEDAR CREST BLVD",
            "city": "ALLENTOWN",
            "state": "PA",
            "postal_code": "181036202",
            "telephone_number": "610-402-8000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2545 Schoenersville Rd",
            "address_purpose": "LOCATION",
            "city": "Bethlehem",
            "state": "PA",
            "postal_code": "180177300",
            "country_code": "US",
            "telephone_number": "610-402-8000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STANCATO",
        "first_name": "JACOB",
        "middle_name": "TYLER",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-10-11",
        "last_updated": "2022-03-15",
        "certification_date": "2022-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "PA",
            "license": "MA063010",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "MA063010",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Allentown, PA

Sources for this page

Verify at the official NPI Registry.