NPIMap

Individual provider Active NPI

Dana Richard Ide, P.A.-C.

  • Physician Assistant
  • Allentown, PA
National Provider Identifier
1861473217
Registry record updated Oct 31, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
MA002895L Issued in PA
Practice address
1250 S Cedar Crest Blvd
Ste 110
Allentown, PA 18103-6224
Phone
(610) 435-1003
Fax
(610) 435-3184
NPI assigned
Nov 10, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 31, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X MA002895L PA Primary

Addresses

Primary practice location

1250 S Cedar Crest Blvd
Ste 110
Allentown, PA 18103-6224

Mailing address

PO Box 1754
Allentown, PA 18105-1754

Other identifiers 5

IdentifierTypeStateIssuer
1958641OtherHIGHMARK BLUE SHIELD
50053198OtherCAPITAL BLUE CROSS
50053198OtherKEYSTONE HEALTH CENTRAL
405198OtherHEALTHAMERICA/HEALTHASSUR
P00261573OtherRAILROAD MEDICARE

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
I20051117000139 PA Practitioner - Physician Assistant 0042239279 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lehigh Valley Physician Group 2,512 clinicians
Phoenix Rehabilitation and Health Services Inc 2,775 clinicians

Practice addresses (Care Compare)

1200 S Cedar Crest Blvd
Allentown, PA 18103-6202

1200 S Cedar Crest Blvd 3Rd FL Kasych
LVPG Burn Surgery
Allentown, PA 18103-6202
Phone (610) 402-8355

1200 S Cedar Crest Blvd FL
1 LVPG Nephrology
Allentown, PA 18103-6202
Phone (610) 402-8510

1210 S Cedar Crest Blvd
Allentown, PA 18103-6235
Phone (610) 402-3888

2000 Westinghouse Dr
Suite 200
Cranberry Township, PA 16066-5238

2100 Mack Blvd
FL 4
Allentown, PA 18103-5622

2545 Schoenersville Rd
Bethlehem, PA 18017-7300

798 Hausman Rd
Allentown, PA 18104-9108
Phone (610) 402-8900

Hospital & facility affiliations

  • Lehigh Valley Hospital Hospital, Allentown, PA, CCN 390133
  • Good Shepherd Rehabilitation Hospital, the Inpatient rehabilitation facility, Center Valley, PA, CCN 393035

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
MA002895LPAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Lehigh Valley Physician Group CurrentSince Dec 1, 2014 Accepting new patients
Lehigh Valley Physician Group CurrentSince Dec 1, 2014 Accepting new patients
Hazleton Professional Services CurrentSince Jun 25, 2023 Accepting new patients
CHS Professional Practice, P.C. Past Accepting new patients
Pulmonary Associates PC Past Accepting new patients

Locations

1210 S Cedar Crest Blvd
Ste 3300
Allentown, PA 18103
Phone (610) 402-8506

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

1250 S Cedar Crest Blvd
Ste 110
Allentown, PA 18103
Phone (610) 435-1003

1503 N Cedar Crest Blvd
Allentown, PA 18104
Phone (610) 871-9110

2775 Schoenersville Rd
Bethlehem, PA 18017

111 Switzgabel Dr
Brodheadsville, PA 18322
Phone (570) 369-1004

505 Independence Rd
East Stroudsburg, PA 18301
Phone (484) 862-3001

26 Station Cir
Hazleton, PA 18202
Phone (570) 861-8710

1000 Alliance Dr
#10
Hazleton, PA 18202
Phone (570) 501-6450

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

237 S Mountain Blvd
Ste 7
Mountain Top, PA 18707
Phone (570) 261-5000

1120 Oak St
Pittston Township, PA 18640
Phone (570) 299-3384

334 Main St
Scranton, PA 18519
Phone (570) 307-1767

241 Claremont Ave
Tamaqua, PA 18252
Phone (570) 225-7211

1411 Jacobsburg Rd
Wind Gap, PA 18091
Phone (484) 861-0493

Interoperability endpoints

  • Direct secure messaging: dide7006@direct2.lvhn.org

Organizations & group practices 11

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 6

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": "1131580800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1414713600000",
    "number": "1861473217",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1754",
            "city": "ALLENTOWN",
            "state": "PA",
            "postal_code": "181051754"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1250 S CEDAR CREST BLVD",
            "address_2": "STE 110",
            "city": "ALLENTOWN",
            "state": "PA",
            "postal_code": "181036224",
            "telephone_number": "610-435-1003",
            "fax_number": "610-435-3184"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IDE",
        "first_name": "DANA",
        "middle_name": "RICHARD",
        "credential": "P.A.-C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-10",
        "last_updated": "2014-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA002895L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIGHMARK BLUE SHIELD",
            "identifier": "1958641",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAPITAL BLUE CROSS",
            "identifier": "50053198",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KEYSTONE HEALTH CENTRAL",
            "identifier": "50053198",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHAMERICA/HEALTHASSUR",
            "identifier": "405198",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00261573",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Allentown, PA

Sources for this page

Verify at the official NPI Registry.