NPIMap

Organization Active NPI

St Luke's Physician Group, Inc

Doing business as St. Luke's Twin Rivers Gastroenterology

  • Gastroenterology Physician
  • Easton, PA
National Provider Identifier
1902406762
Registry record updated Dec 9, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
Legal business name
ST LUKE'S PHYSICIAN GROUP, INC
Doing business as
St. Luke's Twin Rivers Gastroenterology
Practice address
21 Corporate Dr Ste 3
Easton, PA 18045-2664
Phone
(484) 526-4000
NPI assigned
Oct 29, 2020
Last updated
Dec 9, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 9, 2020

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

Authorized official

Name
Sue Chiavaroli
Title
Cvo Supervisor
Phone
(484) 526-3569

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RG0100X Primary

Addresses

Primary practice location

21 Corporate Dr Ste 3
Easton, PA 18045-2664

Mailing address

801 Ostrum St
Bethlehem, PA 18015-1000
Phone (484) 526-3569

Other practice location 1

41 Corporate Dr Ste 101
Easton, PA 18045-2670
Phone (484) 526-4000

Other practice location 2

20 Community Dr
Easton, PA 18045-2658
Phone (610) 258-6635

Other names 1

  • St. Luke's Twin Rivers Gastroenterology Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040226000062 PA Part B Supplier - Clinic/Group Practice 6709798333 Receives reassigned benefits from 3,523 practitioners
This NPI is an additional NPI on the enrollment

National Provider Directory

National Provider Directory

Locations

20 Community Dr
Ste 101
Easton, PA 18045

41 Corporate Dr
Ste 101B
Easton, PA 18045

Practitioners & affiliated clinicians

Practitioners 12

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1603929600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1607472000000",
    "number": "1902406762",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 OSTRUM ST",
            "city": "BETHLEHEM",
            "state": "PA",
            "postal_code": "180151000",
            "telephone_number": "484-526-3569"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 CORPORATE DR STE 3",
            "city": "EASTON",
            "state": "PA",
            "postal_code": "180452664",
            "telephone_number": "484-526-4000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "41 Corporate Dr Ste 101",
            "address_purpose": "LOCATION",
            "city": "Easton",
            "state": "PA",
            "postal_code": "180452670",
            "country_code": "US",
            "telephone_number": "484-526-4000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "20 Community Dr",
            "address_purpose": "LOCATION",
            "city": "Easton",
            "state": "PA",
            "postal_code": "180452658",
            "country_code": "US",
            "telephone_number": "610-258-6635",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "ST LUKE'S PHYSICIAN GROUP, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-10-29",
        "last_updated": "2020-12-09",
        "certification_date": "2020-12-09",
        "status": "A",
        "authorized_official_last_name": "CHIAVAROLI",
        "authorized_official_first_name": "SUE",
        "authorized_official_title_or_position": "CVO SUPERVISOR",
        "authorized_official_telephone_number": "484-526-3569"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Gastroenterology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "St. Luke's Twin Rivers Gastroenterology",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "St. Luke's Twin Rivers Gastroenterology",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Easton, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.