NPIMap

Individual provider Active NPI

Roula H Ainchaibeh, PA-C

  • Medical Physician Assistant
  • Allentown, PA
National Provider Identifier
1891886198
Registry record updated Jan 26, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
MA051747 Issued in PA
Practice address
1250 S Cedar Crest Blvd Ste 405
Allentown, PA 18103-6224
Phone
(610) 402-8420
Fax
(610) 402-1689
NPI assigned
Sep 28, 2006
Last updated
Jan 26, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 26, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X MP00126200 NJ
Medical Physician Assistant 363AM0700X MA051747 PA Primary

Addresses

Primary practice location

1250 S Cedar Crest Blvd Ste 405
Allentown, PA 18103-6224

Mailing address

2100 Mack Blvd FL 4
Allentown, PA 18103-5622
Phone (484) 884-0469

Other practice location 1

3 Cooper Plz
suite 311
Camden, NJ 08103-1438
Phone (856) 342-2034

Other identifiers 1

IdentifierTypeStateIssuer
NEW YORK LICENSEOtherNY010039-1

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
I20120201000522 PA Practitioner - Physician Assistant 2961508684 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2004
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)

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

1250 S Cedar Crest Blvd
Allentown, PA 18103-6224

2100 Mack Blvd
FL 4
Allentown, PA 18103-5622

5649 Wynnewood Dr
Laurys Station, PA 18059-1124

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

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MP00126200NJMDPhysician Assistant
MA051747PAMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Lehigh Valley Physician Group CurrentSince Feb 12, 2018 Accepting new patients
Lehigh Valley Physician Group CurrentSince Feb 12, 2018 Accepting new patients
St. Luke's Physician Group, Inc. CurrentSince Jan 9, 2012 Accepting new patients
St Luke's Physician Group Inc CurrentSince Jan 9, 2012 Accepting new patients
Pulmonary Associates PC Past Accepting new patients

Locations

1250 S Cedar Crest Blvd
Ste 405
Allentown, PA 18103
Phone (610) 402-8420

2100 Mack Blvd
Fl 4
Allentown, PA 18103

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

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

Interoperability endpoints

  • Direct secure messaging: rainchaibeh268340@direct2.lvhn.org

Organizations & group practices 7

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 11

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": "1159401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1516924800000",
    "number": "1891886198",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 MACK BLVD FL 4",
            "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 405",
            "city": "ALLENTOWN",
            "state": "PA",
            "postal_code": "181036224",
            "telephone_number": "610-402-8420",
            "fax_number": "610-402-1689"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3 Cooper Plz",
            "address_2": "suite 311",
            "address_purpose": "LOCATION",
            "city": "Camden",
            "state": "NJ",
            "postal_code": "081031438",
            "country_code": "US",
            "telephone_number": "856-342-2034",
            "fax_number": "856-342-6608",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "AINCHAIBEH",
        "first_name": "ROULA",
        "middle_name": "H",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-28",
        "last_updated": "2018-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NJ",
            "license": "MP00126200",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "PA",
            "license": "MA051747",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "010039-1",
            "identifier": "NEW YORK LICENSE",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Allentown, PA

Sources for this page

Verify at the official NPI Registry.