NPIMap

Individual provider Active NPI

Rakesh Dussa

  • Family Medicine Physician
  • Allentown, PA
National Provider Identifier
1831624196
Registry record updated Oct 1, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD471146 Issued in PA
Practice address
3080 Hamilton Blvd Ste 250
Allentown, PA 18103-3694
NPI assigned
Apr 25, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 1, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 01012676411 VA
Family Medicine Physician 207Q00000X MD471146 PA Primary

Addresses

Primary practice location

3080 Hamilton Blvd Ste 250
Allentown, PA 18103-3694

Mailing address

13540 Hull Street Road
Midlothian, VA 23112
Phone (804) 595-1418

Other practice location 1

13540 Hull Street Rd
Midlothian, VA 23112-2107
Phone (804) 595-1418

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
I20201007000355 PA Practitioner - Family Practice 2365772506 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2017
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)

3080 Hamilton Blvd
Suite 250
Allentown, PA 18103-3694
Phone (610) 437-0739

Hospital & facility affiliations

  • Bayada Home Health Care, Inc. Home health agency, Allentown, PA, CCN 397533
  • Lehigh Valley Hospital Hospital, Allentown, PA, CCN 390133
  • St Lukes Hospital Hospital, Bethlehem, PA, CCN 390049
  • Good Shepherd Rehabilitation Hospital, the Inpatient rehabilitation facility, Center Valley, PA, CCN 393035

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of skin lesions18
Removal or shaving of skin growth1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
01012676411VAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lehigh Valley Physician Group Family Medicine CurrentSince Sep 5, 2020 Accepting new patients
Lehigh Valley Physician Group Family Medicine CurrentSince Sep 5, 2020 Accepting new patients
Lehigh Valley Physician Group Family Medicine Current Accepting new patients

Locations

1101 S Cedar Crest Blvd
Ste 200
Allentown, PA 18103

3080 Hamilton Blvd
Ste 250
Allentown, PA 18103
Phone (610) 437-0739

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

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

Organizations & group practices 4

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 13

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1493078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601510400000",
    "number": "1831624196",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13540 HULL STREET ROAD",
            "city": "MIDLOTHIAN",
            "state": "VA",
            "postal_code": "23112",
            "telephone_number": "804-595-1418"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3080 HAMILTON BLVD STE 250",
            "city": "ALLENTOWN",
            "state": "PA",
            "postal_code": "181033694"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "13540 Hull Street Rd",
            "address_purpose": "LOCATION",
            "city": "Midlothian",
            "state": "VA",
            "postal_code": "231122107",
            "country_code": "US",
            "telephone_number": "804-595-1418",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DUSSA",
        "first_name": "RAKESH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-04-25",
        "last_updated": "2020-10-01",
        "certification_date": "2020-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "VA",
            "license": "01012676411",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "MD471146",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Allentown, PA

Sources for this page

Verify at the official NPI Registry.