Individual provider Active NPI

Marissa Weidner, CRNP

  • Nurse Practitioner
  • Bethlehem, PA
National Provider Identifier
1861374134
Registry record updated Jul 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
SP028886 Issued in PA
Practice address
801 Ostrum St
Bethlehem, PA 18015-1000
Phone
(484) 526-2200
NPI assigned
Jul 25, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 25, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X SP028886 PA Primary

Addresses

Primary practice location

801 Ostrum St
Bethlehem, PA 18015-1000

Mailing address

26 Red Tail CT
Limerick, PA 19468-1489
Phone (484) 942-8962

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
I20251002000726 PA Practitioner - Nurse Practitioner 5092211664 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Lukes Physician Group IncGroup PAC ID 6709798333, 2,161 clinicians

Practice addresses (Care Compare)

1021 Park Ave
Quakertown, PA 18951-0130

1736 Hamilton St
Allentown, PA 18104-5656
Phone (484) 526-8142

1736 W Hamilton St
Allentown, PA 18104-5656
Phone (610) 954-3571

3000 St Lukes Dr
Quakertown, PA 18951-1696
Phone (484) 526-3950

801 Ostrm St
Bethlehem, PA 18015-1000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
SP028886PAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
St. Luke'S Physician Group, Inc. CurrentSince Oct 6, 2025 Accepting new patients
St Luke'S Physician Group Inc CurrentSince Oct 6, 2025 Accepting new patients
St. Luke'S Physician Group, Inc. Current Accepting new patients
Gslpg, Inc CurrentSince Oct 6, 2025 Accepting new patients
Gslpg Inc Past Accepting new patients

Locations

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

100 Paramount Blvd
Orwigsburg, PA 17961
Phone (272) 639-1000

Organizations & group practices 5

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 7

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": "1753401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753401600000",
    "number": "1861374134",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26 RED TAIL CT",
            "city": "LIMERICK",
            "state": "PA",
            "postal_code": "194681489",
            "telephone_number": "484-942-8962"
        },
        {
            "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": "484-526-2200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEIDNER",
        "first_name": "MARISSA",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-07-25",
        "last_updated": "2025-07-25",
        "certification_date": "2025-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "PA",
            "license": "SP028886",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bethlehem, PA

Sources for this page

Verify at the official NPI Registry.