St. Luke'S Physician Group, Inc.
Organization Active NPI Family Medicine Physician · Wind Gap, PA
NPI 1811214950 · NPPES record last updated Apr 29, 2010
Key facts
- NPI
- 1811214950
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Family Medicine Physician 207Q00000X
- Legal business name
- ST. LUKE'S PHYSICIAN GROUP, INC.
- Practice address
- 131 S Broadway
Wind Gap, PA 18091-1425 - Phone
- (610) 863-7888
- Fax
- (610) 863-1081
- NPI assigned
- Apr 29, 2010
- Organization subpart
- No
Authorized official
- Name
- Dean W Evans
- Title
- Enrollment Coordinator
- Phone
- (610) 954-4991
Corporate family (same tax ID) 24
Practitioners 8
-
Andreea Davis, M.D.
-
Mahnaz Hussain, MD
-
Edward Douglas Hutson Jr., D.P.M.
-
Heather C McTigue, CRNP
-
Daniel Plavin, MD
-
Amulia Rai, DO
-
Anuradha Silvonek, M.D.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in PA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040226000062 | PA | Part B Supplier - Clinic/Group Practice | 6709798333 |
Receives reassigned benefits from 3,523 practitioners This NPI is an additional NPI on the enrollment |
National Provider Directory
- Tax ID family
- Upper Bucks Emergency M
Locations
5445 Lanark Rd
Ste 200
Center Valley, PA 18034
Phone (484) 526-7036
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician |
207Q00000X | PA | Yes |
Addresses
Primary practice location
131 S Broadway
Wind Gap, PA 18091-1425
Mailing address
801 Ostrum St
Enrollment Center
Bethlehem, PA 18015-1000
Phone (610) 863-7888
Other names
- ST. LUKE'S FAMILY PRACTICE WIND GAP
Other providers in Wind Gap, PA
- Slate Belt Family Practice PC
- St. Luke'S Hospital Bethlehem
- St. Luke'S Hosptial
- St. Luke'S Physician Group Inc
- St. Luke'S Physician Group, Inc.
- Robert S Stasak
- Sarah Elizabeth Stein
- Kenneth P Sun
- Valerie Lynn Szmaciasz
- Donna L Vojtasek
All providers in Wind Gap, PA · Family Medicine Physician in Pennsylvania
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 29, 2010. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.