NPIMap

Individual provider Active NPI

Brian Kendall Civic, M.D.

  • Critical Care Medicine (Internal Medicine) Physician
  • Allentown, PA
National Provider Identifier
1780844555
Registry record updated Apr 6, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Care Medicine (Internal Medicine) PhysicianTaxonomy code 207RC0200X
License
MD437767 Issued in PA
Practice address
1250 S Cedar Crest Blvd
Suite 205
Allentown, PA 18103-6224
Phone
(610) 402-9116
Fax
(610) 402-9610
NPI assigned
Jun 14, 2008
Last updated
Apr 6, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 6, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MT191001 PA
Critical Care Medicine (Internal Medicine) Physician 207RC0200X MD437767 PA Primary
Pulmonary Disease Physician 207RP1001X MD437767 PA

Addresses

Primary practice location

1250 S Cedar Crest Blvd
Suite 205
Allentown, PA 18103-6224

Mailing address

PO Box 783311
Philadelphia, PA 19178-3311
Phone (484) 884-4500

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130903000209 PA Practitioner - Pulmonary DiseasePractitioner - Internal MedicinePractitioner - Critical Care (Intensivists)Practitioner - Endocrinology 1052554540 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pulmonary DiseaseAlso: Critical Care (Intensivists)
Education
Temple University School of Medicine, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Lehigh Valley Physician GroupGroup PAC ID 3072425123, 2,512 clinicians

Practice addresses (Care Compare)

17 TH and Chew St
101 LV Specialty Care Physicians Practice
Allentown, PA 18102-3698
Phone (610) 969-4370

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MT191001PAMDInternal Medicine Physician
MD437767PAMDPulmonary Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Schuylkill Health System Medical Group, Inc. Internal Medicine CurrentSince Sep 11, 2017 Accepting new patients
Lehigh Valley Physician Group CurrentSince Jul 30, 2024 Accepting new patients
Family Care Centers Inc Internal Medicine CurrentSince Jan 30, 2020 Accepting new patients
Lehigh Valley Physician Group Internal Medicine Current Accepting new patients
Schuylkill Health System Medical Group, Inc. Internal Medicine CurrentSince Sep 11, 2017 Accepting new patients
Family Care Centers Inc. Internal Medicine Current Accepting new patients
Lehigh Valley Physician Group CurrentSince Feb 1, 2019 Accepting new patients
Hazleton Professional Services Internal Medicine CurrentSince Feb 1, 2019 Accepting new patients
Lehigh Valley Physician Group Internal Medicine CurrentSince Jul 30, 2024 Accepting new patients

Locations

1250 S Cedar Crest Blvd
Ste 205
Allentown, PA 18103
Phone (610) 402-9116

2100 Mack Blvd
Fl 4
Allentown, PA 18103

500 Plaza Ct
East Stroudsburg, PA 18301
Phone (570) 426-2330

50 Moisey Dr
Ste 109
Hazle Township, PA 18202
Phone (570) 501-6460

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

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

420 S Jackson St
Pottsville, PA 17901
Phone (570) 621-5000

700 E Norwegian St
Pottsville, PA 17901
Phone (570) 621-4000

700 Schuylkill Manor Rd
Ste 3
Pottsville, PA 17901
Phone (570) 621-4440

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

Interoperability endpoints

  • Direct secure messaging: bcivic11742@direct2.lvhn.org

Organizations & group practices 10

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.

Hospital & facility affiliations 11

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": "1213401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1586131200000",
    "number": "1780844555",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 783311",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191783311",
            "telephone_number": "484-884-4500",
            "fax_number": "484-884-0699"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1250 S CEDAR CREST BLVD",
            "address_2": "SUITE 205",
            "city": "ALLENTOWN",
            "state": "PA",
            "postal_code": "181036224",
            "telephone_number": "610-402-9116",
            "fax_number": "610-402-9610"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CIVIC",
        "first_name": "BRIAN",
        "middle_name": "KENDALL",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-06-14",
        "last_updated": "2020-04-06",
        "certification_date": "2020-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MT191001",
            "primary": false
        },
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "PA",
            "license": "MD437767",
            "primary": true
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "PA",
            "license": "MD437767",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Allentown, PA

Sources for this page

Verify at the official NPI Registry.