NPIMap

Individual provider Active NPI

Kenneth J Brislin, MD

  • Sports Medicine (Orthopaedic Surgery) Physician
  • Allentown, PA
National Provider Identifier
1922090257
Registry record updated Jan 16, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Orthopaedic Surgery) PhysicianTaxonomy code 207XX0005X
License
MD074181L Issued in PA
Practice address
250 Cetronia Road
Suite 303
Allentown, PA 18104-9168
Phone
(610) 973-6200
Fax
(610) 973-6546
NPI assigned
Aug 23, 2005
Last updated
Jan 16, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X MD074181L PA
Sports Medicine (Orthopaedic Surgery) Physician 207XX0005X MD074181L PA Primary

Addresses

Primary practice location

250 Cetronia Road
Suite 303
Allentown, PA 18104-9168

Mailing address

PO Box 848269
Boston, MA 02284-8269
Phone (610) 973-1700

Other identifiers 11

IdentifierTypeStateIssuer
1637940OtherPAAMERIHEALTH ADMIN
89078OtherPAGEISINGER
1637940OtherPABLUE SHIELD
50041754OtherPABLUE CROSS
821238OtherPAFIRST PRIORITY HEALTH
P00146237OtherPARAILROAD MEDICARE
7716478OtherPAAETNA
P3462562OtherPAOXFORD
1011059120001MedicaidPA
2000705OtherPAKEYSTONE CENTRAL
2312743000OtherPAKEYSTONE EAST

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
I20040818000393 PA Practitioner - Orthopedic Surgery 3870566847 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
Temple University School of Medicine, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Phoenix Rehabilitation and Health Services IncGroup PAC ID 3476464298, shared by 2 NPIs, 2,775 clinicians

Practice addresses (Care Compare)

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

250 Cetronia Rd
Suite 303
Allentown, PA 18104-9168
Phone (610) 973-6200

506 Hazle St
Wilkes Barre, PA 18702-4646
Phone (570) 270-4366

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
89.41 of 100Reported as individual
Quality
86.16
Promoting interoperability
100
Improvement activities
40
Cost
78.55

Procedures performed for Medicare patients

ProcedureNumber of procedures
Knee replacement29
Lower limb (leg) arthroscopy (minimally invasive joint repair)1-10
Upper limb (arm) arthroscopy (minimally invasive joint repair)17

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD074181LPAMDOrthopaedic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Orthopaedic Associates of Allentown CurrentSince Aug 23, 2004 Accepting new patients
Orthopaedic Associates of Allentown Orthopaedic Surgery CurrentSince Aug 23, 2004 Accepting new patients
Mississippi Sports Medicine & Orthopaedic Center Orthopaedic Surgery Past Accepting new patients

Locations

1243 S Cedar Crest Blvd
Lowr 2
Allentown, PA 18103
Phone (610) 433-6045

250 Cetronia Rd
Allentown, PA 18104
Phone (610) 402-9090

250 Cetronia Rd
Ste 200
Allentown, PA 18104

250 Cetronia Rd
Ste 300
Allentown, PA 18104
Phone (484) 223-2880

250 Cetronia Rd
Ste 303
Allentown, PA 18104

2045 Westgate Dr
Bethlehem, PA 18017
Phone (610) 865-8177

1241 Blakeslee Boulevard Dr E
Lehighton, PA 18235
Phone (570) 386-6900

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 16

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1124755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1389830400000",
    "number": "1922090257",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 848269",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022848269",
            "telephone_number": "610-973-1700",
            "fax_number": "610-973-1778"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 CETRONIA ROAD",
            "address_2": "SUITE 303",
            "city": "ALLENTOWN",
            "state": "PA",
            "postal_code": "181049168",
            "telephone_number": "610-973-6200",
            "fax_number": "610-973-6546"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRISLIN",
        "first_name": "KENNETH",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-23",
        "last_updated": "2014-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "PA",
            "license": "MD074181L",
            "primary": false
        },
        {
            "code": "207XX0005X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": "PA",
            "license": "MD074181L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIHEALTH ADMIN",
            "identifier": "1637940",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GEISINGER",
            "identifier": "89078",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "1637940",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "50041754",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIRST PRIORITY HEALTH",
            "identifier": "821238",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00146237",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7716478",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD",
            "identifier": "P3462562",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1011059120001",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KEYSTONE CENTRAL",
            "identifier": "2000705",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KEYSTONE EAST",
            "identifier": "2312743000",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Allentown, PA

Sources for this page

Verify at the official NPI Registry.