NPIMap

Organization Active NPI

St. Luke's Hospital

  • Psychiatric Hospital Unit
  • Bethlehem, PA
National Provider Identifier
1780788034
Registry record updated Aug 22, 2020
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Key facts

NPPES NPI Registry
Primary specialty
Psychiatric Hospital UnitTaxonomy code 273R00000X
License
451201 Issued in PA
Legal business name
ST. LUKE'S HOSPITAL
Practice address
801 Ostrum St
Bethlehem, PA 18015-1000
Phone
(610) 954-4000
NPI assigned
Sep 8, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Ms. Andrea T Rosko
Title
Executive Director, Slpho
Phone
(610) 954-4132

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric Hospital Unit 273R00000X 451201 PA Primary

Addresses

Primary practice location

801 Ostrum St
Bethlehem, PA 18015-1000

Mailing address

801 Ostrum St
Bethlehem, PA 18015-1000
Phone (610) 954-4000

Other identifiers 1

IdentifierTypeStateIssuer
1007552510032MedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090402000107 PA Part A Provider - Hospital 0648189688 3 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Lehighton, PA; Allentown, PA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1780788034. Details of each certification follow.

Hospital certification: CCN 39S049

Legal name
ST LUKE'S HOSPITAL
Organization structure
CorporationNon-profit
Incorporated
May 29, 1872 in PA
Enrollment address
421 W Chew St
Allentown, PA 18102-3046
Hospital Psychiatric Unit
Hospital subgroups
Psychiatric unit

Facilities connected through Provider of Services related, parent or unit certification numbers.

Other NPIs on the same Medicare enrollment 3

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

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 4

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

NameRoleSinceShare
Richard Anderson Individual Corporate OfficerPresident and Ceo Dec 1, 1986 100%
Corporate DirectorPresident and Ceo Dec 1, 1986 100%
W-2 Managing EmployeePresident and Ceo Dec 1, 1986 100%
St Luke's Health Network Inc Organization, Bethlehem, PA Created for acquisition, Non-profit 5% Or Greater Direct Ownership Interest May 29, 1966 100%
Robert L Wax Individual Corporate OfficerSenior VP Nov 1, 2021
W-2 Managing EmployeeSenior VP Nov 1, 2021
Francine Botek Individual Corporate OfficerSenior VP Exec Admin Nov 1, 2021
W-2 Managing EmployeeSenior VP Exec Admin Nov 1, 2021

NPI Registry JSON

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

{
    "created_epoch": "1157673600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1780788034",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 OSTRUM ST",
            "city": "BETHLEHEM",
            "state": "PA",
            "postal_code": "180151000",
            "telephone_number": "610-954-4000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 OSTRUM ST",
            "city": "BETHLEHEM",
            "state": "PA",
            "postal_code": "180151000",
            "telephone_number": "610-954-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST. LUKE'S HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-08",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ROSKO",
        "authorized_official_first_name": "ANDREA",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR, SLPHO",
        "authorized_official_telephone_number": "610-954-4132",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "273R00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Unit",
            "state": "PA",
            "license": "451201",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1007552510032",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bethlehem, PA

Sources for this page

Verify at the official NPI Registry.