NPIMap

Individual provider Active NPI

Eric Radutman

  • Internal Medicine Physician
  • Bethlehem, PA
National Provider Identifier
1912435413
Registry record updated Oct 8, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD472009 Issued in PA
Practice address
2649 Schoenersville Rd Ste 201
Bethlehem, PA 18017-7316
Phone
(484) 884-0617
Fax
(484) 884-0628
NPI assigned
May 27, 2017
Last updated
Oct 8, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 8, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MT213680 PA
Internal Medicine Physician 207R00000X MD472009 PA Primary

Addresses

Primary practice location

2649 Schoenersville Rd Ste 201
Bethlehem, PA 18017-7316

Mailing address

2100 Mack Blvd
Allentown, PA 18103-5622
Phone (484) 884-0617

Other practice location 1

1001 S George St
York, PA 17403-3676
Phone (717) 741-8003

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
I20201014000493 PA Practitioner - Internal Medicine 9537431515 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

777 Township Line Rd
FL 1
Yardley, PA 19067-5552
Phone (215) 860-0775

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD472009PAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Clinical Care Associates of the University of Pennsylvania Health CurrentSince Aug 1, 2024 Accepting new patients
Clinical Care Associates of the University of Pennsylvania Health Syst CurrentSince Aug 1, 2024 Accepting new patients
Clinical Care Associates of the University of Pennsylvania Health Internal Medicine Current Accepting new patients
Clinical Care Associates of the University of Pennsylvania Health Syst Internal Medicine Past Accepting new patients

Locations

777 Township Line Rd
Fl 1
Yardley, PA 19067
Phone (215) 860-0775

777 Township Line Rd
Ste 200
Yardley, PA 19067
Phone (215) 860-0775

Organizations & group practices 4

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 9

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": "1495843200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602115200000",
    "number": "1912435413",
    "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": "484-884-0617",
            "fax_number": "484-884-0628"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2649 SCHOENERSVILLE RD STE 201",
            "city": "BETHLEHEM",
            "state": "PA",
            "postal_code": "180177316",
            "telephone_number": "484-884-0617",
            "fax_number": "484-884-0628"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1001 S George St",
            "address_purpose": "LOCATION",
            "city": "York",
            "state": "PA",
            "postal_code": "174033676",
            "country_code": "US",
            "telephone_number": "717-741-8003",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RADUTMAN",
        "first_name": "ERIC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-05-27",
        "last_updated": "2020-10-08",
        "certification_date": "2020-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MT213680",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MD472009",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bethlehem, PA

Sources for this page

Verify at the official NPI Registry.