NPIMap

Organization Active NPI

St. Luke's Physician Group, Inc.

Doing business as St. Luke's Pediatric Critical Care Associates

  • Pediatric Critical Care Medicine Physician
  • Bethlehem, PA
National Provider Identifier
1811535982
Registry record updated Dec 19, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Critical Care Medicine PhysicianTaxonomy code 2080P0203X
Legal business name
ST. LUKE'S PHYSICIAN GROUP, INC.
Doing business as
St. Luke's Pediatric Critical Care Associates
Practice address
801 Ostrum St
Bethlehem, PA 18015-1000
Phone
(484) 526-4999
Fax
(833) 213-6248
NPI assigned
Dec 19, 2019
Last updated
Dec 19, 2019By the provider in NPPES
Organization subpart
Yes
Parent organization
ST. LUKE'S PHYSICIAN GROUP, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 19, 2019

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

Authorized official

Name
Sue Chiavaroli
Title
Enrollment Supervisor
Phone
(484) 526-3569

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Critical Care Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2080P0203X Primary

Addresses

Primary practice location

801 Ostrum St
Bethlehem, PA 18015-1000

Mailing address

801 Ostrum St
Bethlehem, PA 18015-1000
Phone (484) 526-4999

Other names 1

  • St. Luke's Pediatric Critical Care Associates Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
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

National Provider Directory
Part of
Orthopaedic Surgical GR

Practitioners & affiliated clinicians

Practitioners 16

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1576713600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1576713600000",
    "number": "1811535982",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 OSTRUM ST",
            "city": "BETHLEHEM",
            "state": "PA",
            "postal_code": "180151000",
            "telephone_number": "484-526-4999",
            "fax_number": "833-213-6248"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 OSTRUM ST",
            "city": "BETHLEHEM",
            "state": "PA",
            "postal_code": "180151000",
            "telephone_number": "484-526-4999",
            "fax_number": "833-213-6248"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST. LUKE'S PHYSICIAN GROUP, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ST. LUKE'S PHYSICIAN GROUP, INC.",
        "enumeration_date": "2019-12-19",
        "last_updated": "2019-12-19",
        "certification_date": "2019-12-19",
        "status": "A",
        "authorized_official_last_name": "CHIAVAROLI",
        "authorized_official_first_name": "SUE",
        "authorized_official_title_or_position": "ENROLLMENT SUPERVISOR",
        "authorized_official_telephone_number": "484-526-3569"
    },
    "taxonomies": [
        {
            "code": "2080P0203X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics, Pediatric Critical Care Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "St. Luke's Pediatric Critical Care Associates",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bethlehem, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.