Individual provider Active NPI

Kristin Scrbacic, CRNP

  • Acute Care Nurse Practitioner
  • Allentown, PA
National Provider Identifier
1861906570
Registry record updated Nov 17, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
SP018126 Issued in PA
Practice address
1250 S Cedar Crest Blvd Ste 205
Allentown, PA 18103-6271
Phone
(610) 402-9116
Fax
(610) 402-9610
NPI assigned
Nov 17, 2017
Last updated
Nov 17, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 17, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X SP018126 PA Primary

Addresses

Primary practice location

1250 S Cedar Crest Blvd Ste 205
Allentown, PA 18103-6271

Mailing address

2100 Mack Blvd
Allentown, PA 18103-5622
Phone (484) 884-0469

Other names 1

  • Kristin Weller Former name

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
I20171211000187 PA Practitioner - Nurse Practitioner 3779841275 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lehigh Valley Physician GroupGroup PAC ID 3072425123, 2,512 clinicians

Practice addresses (Care Compare)

1250 S Cedar Crest Blvd
205 LVPG Pulmonary and Critical Care Medici
Allentown, PA 18103-6224
Phone (610) 439-8856

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Lehigh Valley Physician Group CurrentSince Nov 20, 2017 Accepting new patients
Lehigh Valley Physician Group CurrentSince Nov 20, 2017 Accepting new patients
Lehigh Valley Physician Group Current Accepting new patients
Pulmonary Associates PC Past Accepting new patients

Locations

1250 S Cedar Crest Blvd
Ste 205
Allentown, PA 18103
Phone (610) 402-9116

2100 Mack Blvd
Fl 4
Allentown, PA 18103

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

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 5

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": "1510876800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1510876800000",
    "number": "1861906570",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 MACK BLVD",
            "city": "ALLENTOWN",
            "state": "PA",
            "postal_code": "181035622",
            "telephone_number": "484-884-0469",
            "fax_number": "484-884-0628"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1250 S CEDAR CREST BLVD STE 205",
            "city": "ALLENTOWN",
            "state": "PA",
            "postal_code": "181036271",
            "telephone_number": "610-402-9116",
            "fax_number": "610-402-9610"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCRBACIC",
        "first_name": "KRISTIN",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-11-17",
        "last_updated": "2017-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "PA",
            "license": "SP018126",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KRISTIN",
            "last_name": "WELLER",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Allentown, PA

Sources for this page

Verify at the official NPI Registry.