Individual provider Active NPI

Angelo A Baccala Jr., MD

  • Urology Physician
  • Allentown, PA
National Provider Identifier
1811019797
Registry record updated Nov 27, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
MD440304 Issued in PA
Practice address
1250 S Cedar Crest Blvd
Suite 210
Allentown, PA 18103-6224
Phone
(610) 402-6986
Fax
(610) 402-1682
NPI assigned
Apr 4, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 27, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X MD440304 PA Primary

Addresses

Primary practice location

1250 S Cedar Crest Blvd
Suite 210
Allentown, PA 18103-6224

Mailing address

PO Box 783311
Philadelphia, PA 19178-3311

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100914000347 PA Practitioner - Urology 7810065612 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
Johns Hopkins University School of Medicine, 2002
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)

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

1627 Chew St
Allentown, PA 18102-3648
Phone (610) 969-2226

1627 W Chew St 3Rd FL
LVPG Mental Health Clinic 17TH St
Allentown, PA 18102-3648
Phone (610) 402-1155

2100 Mack Blvd
FL 4
Allentown, PA 18103-5622

2545 Schoenersville Rd
Bethlehem, PA 18017-7300

2597 Schoenersville Rd
Bethlehem, PA 18017-7325
Phone (610) 402-3560

401 N 17TH St
203 LVPG Adolescent Medicine
Allentown, PA 18104-5052
Phone (484) 664-2450

5649 Wynnewood Dr
Laurys Station, PA 18059-1124

Hospital & facility affiliations

  • Lehigh Valley Home Care Home health agency, Allentown, PA, CCN 397023
  • Lehigh Valley Hospital Hospital, Allentown, PA, CCN 390133
  • Lehigh Valley Hospital - Hazleton Hospital, Hazleton, PA, CCN 390185
  • Lehigh Valley Hospital - Pocono Hospital, East Stroudsburg, PA, CCN 390201

Procedures performed for Medicare patients

ProcedureNumber of procedures
Prostate resection16

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD440304PAMDUrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lehigh Valley Physician Group Current Accepting new patients
Lehigh Valley Physician Group CurrentSince Jul 1, 2010 Accepting new patients
Family Care Centers Inc. CurrentSince May 1, 2023 Accepting new patients
Family Care Centers Inc CurrentSince May 1, 2023 Accepting new patients
Hazleton Professional Services CurrentSince May 1, 2021 Accepting new patients
Lehigh Valley Physician Group CurrentSince May 1, 2021 Accepting new patients
Lehigh Valley Physician Group Urology CurrentSince Jul 1, 2010 Accepting new patients
Pulmonary Associates PC Past Accepting new patients
Lehigh Valley Hospital Past Accepting new patients

Locations

1250 S Cedar Crest Blvd
Ste 210
Allentown, PA 18103
Phone (610) 402-6986

2100 Mack Blvd
Allentown, PA 18103
Phone (484) 224-1892

1250 S Cedar Crest Blvd
Ste 215
Allentown, PA 18103
Phone (610) 402-6986

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

422 Normal St
East Stroudsburg, PA 18301
Phone (570) 424-2100

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

50 Moisey Dr
Ste 214
Hazle Township, PA 18202
Phone (570) 501-6900

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

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

Interoperability endpoints

  • Direct secure messaging: abaccala11632@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 and National Provider Directory roles.

Hospital & facility affiliations 8

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": "1175644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1448582400000",
    "number": "1811019797",
    "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"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1250 S CEDAR CREST BLVD",
            "address_2": "SUITE 210",
            "city": "ALLENTOWN",
            "state": "PA",
            "postal_code": "181036224",
            "telephone_number": "610-402-6986",
            "fax_number": "610-402-1682"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BACCALA",
        "first_name": "ANGELO",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-04",
        "last_updated": "2015-11-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "PA",
            "license": "MD440304",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Allentown, PA

Sources for this page

Verify at the official NPI Registry.