NPIMap

Individual provider Active NPI

Dominic P. Rachiele, DMD

  • Oral and Maxillofacial Surgery (Dentist)
  • Bethlehem, PA
National Provider Identifier
1790728814
Registry record updated Oct 23, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
DS 035584 Issued in PA
Practice address
1521 8TH Ave
Suite 100
Bethlehem, PA 18018-1865
Phone
(610) 865-8077
Fax
(610) 865-8112
NPI assigned
Jun 14, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 23, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist) 1223S0112X DS 035584 PA Primary

Addresses

Primary practice location

1521 8TH Ave
Suite 100
Bethlehem, PA 18018-1865

Mailing address

1521 8TH Ave
Suite 100
Bethlehem, PA 18018-1865
Phone (610) 865-8077

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
I20060501000295 PA Practitioner - Oral SurgeryPractitioner - Maxillofacial Surgery 2769491240 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Oral Surgery
Education
Other, 1997
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)

1581 N 9TH St
Suite 101
Stroudsburg, PA 18360-7531
Phone (484) 526-6200

Hospital & facility affiliations

  • St Lukes Hospital Hospital, Bethlehem, PA, CCN 390049

Merit-based Incentive Payment System (MIPS)

Final score
97.13 of 100Reported as apm
Quality
82.27
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DS 035584PAMDOral and Maxillofacial Surgery (Dentist)
3272NHMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
St. Luke'S Physician Group, Inc. Current Accepting new patients
St. Luke'S Physician Group, Inc. CurrentSince May 1, 2006 Accepting new patients
St Luke'S Physician Group Inc CurrentSince May 1, 2006 Accepting new patients
St. Luke'S Physician Group, Inc Past Accepting new patients
St. Luke'S Physician Group, Inc. Past Accepting new patients

Locations

1530 8th Ave
Ste 200
Bethlehem, PA 18018
Phone (610) 861-8007

1521 8th Ave
Ste 101
Bethlehem, PA 18018

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

1419 N 9th St
Stroudsburg, PA 18360
Phone (570) 424-7644

1581 N 9th St
Ste 101
Stroudsburg, PA 18360
Phone (272) 721-2062

Interoperability endpoints

  • Direct secure messaging: dominic.rachiele@slpg.direct-sluhn.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 6

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": "1150243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1224720000000",
    "number": "1790728814",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1521 8TH AVE",
            "address_2": "SUITE 100",
            "city": "BETHLEHEM",
            "state": "PA",
            "postal_code": "180181865",
            "telephone_number": "610-865-8077",
            "fax_number": "610-865-8112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1521 8TH AVE",
            "address_2": "SUITE 100",
            "city": "BETHLEHEM",
            "state": "PA",
            "postal_code": "180181865",
            "telephone_number": "610-865-8077",
            "fax_number": "610-865-8112"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RACHIELE",
        "first_name": "DOMINIC",
        "middle_name": "P.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-14",
        "last_updated": "2008-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "PA",
            "license": "DS 035584",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bethlehem, PA

Sources for this page

Verify at the official NPI Registry.