Individual provider Active NPI

Susan B Holecz, CRNP

  • Pediatric Nurse Practitioner
  • Bethlehem, PA
National Provider Identifier
1811193733
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
UP002143D Issued in PA
Practice address
240 Union Station PLZ
Bethlehem, PA 18015-1281
Phone
(610) 954-3060
Fax
(610) 954-4317
NPI assigned
Jun 26, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X UP002143D PA Primary

Addresses

Primary practice location

240 Union Station PLZ
Bethlehem, PA 18015-1281

Mailing address

623 E Broad St
2ND FLR
Bethlehem, PA 18018-6332
Phone (610) 954-6048

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
I20120109000921 PA Practitioner - Nurse Practitioner 9133395338 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
UP002143DPAMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
St. Luke's Physician Group, Inc. Current Accepting new patients
St. Luke's Physician Group, Inc CurrentSince Jan 26, 2023 Accepting new patients
St. Luke's Physician Group, Inc. Past Accepting new patients

Locations

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

Interoperability endpoints

  • Direct secure messaging: susan.holecz@slpg.direct-sluhn.org

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1182816000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1811193733",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "623 E BROAD ST",
            "address_2": "2ND FLR",
            "city": "BETHLEHEM",
            "state": "PA",
            "postal_code": "180186332",
            "telephone_number": "610-954-6048",
            "fax_number": "610-954-3189"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "240 UNION STATION PLZ",
            "city": "BETHLEHEM",
            "state": "PA",
            "postal_code": "180151281",
            "telephone_number": "610-954-3060",
            "fax_number": "610-954-4317"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLECZ",
        "first_name": "SUSAN",
        "middle_name": "B",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "PA",
            "license": "UP002143D",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bethlehem, PA

Sources for this page

Verify at the official NPI Registry.