Individual provider Active NPI

Omer Choudry, MD

  • Neonatal-Perinatal Medicine Physician
  • Allentown, PA
National Provider Identifier
1922396647
Registry record updated Sep 6, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neonatal-Perinatal Medicine PhysicianTaxonomy code 2080N0001X
License
MD467857 Issued in PA
Practice address
1200 S Cedar Crest Blvd
Allentown, PA 18103
Phone
(610) 402-7632
Fax
(610) 402-7600
NPI assigned
Jul 15, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 6, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Neonatal-Perinatal Medicine Physician 2080N0001X MD467857 PA Primary
Pediatrics Physician 208000000X 25MA08964300 NJ

Addresses

Primary practice location

1200 S Cedar Crest Blvd
Allentown, PA 18103

Mailing address

PO Box 783311
Philadelphia, PA 19178-3311
Phone (484) 884-4500

Other practice location 1

25 Pocono Rd
Denville, NJ 07834-2954
Phone (973) 595-0600

Other practice location 2

25 Pocono Rd
Denville, NJ 07834-2954
Phone (973) 595-0600

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190926001486 PA Practitioner - Pediatric Medicine 2769712280 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MA08964300NJMDPediatrics Physician
MD467857PAMDNeonatal-Perinatal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Family Care Centers Inc. Pediatrics CurrentSince Aug 31, 2022 Accepting new patients
Family Care Centers Inc CurrentSince Aug 31, 2022 Accepting new patients
Lehigh Valley Physician Group CurrentSince Aug 26, 2019 Accepting new patients
Lehigh Valley Physician Group Pediatrics Current Accepting new patients
Lehigh Valley Physician Group CurrentSince Aug 26, 2019 Accepting new patients
Lehigh Valley Hospital Past Accepting new patients
Lehigh Valley Hospital Past Accepting new patients

Locations

2100 Mack Blvd
Allentown, PA 18103
Phone (484) 224-1892

1200 S Cedar Crest Blvd
Allentown, PA 18103
Phone (484) 862-3200

206 E Brown St
East Stroudsburg, PA 18301
Phone (570) 420-4951

500 Plaza Ct
East Stroudsburg, PA 18301
Phone (570) 426-2330

Organizations & group practices 8

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1310688000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1567728000000",
    "number": "1922396647",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 783311",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191783311",
            "telephone_number": "484-884-4500",
            "fax_number": "484-884-0699"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 S CEDAR CREST BLVD",
            "city": "ALLENTOWN",
            "state": "PA",
            "postal_code": "18103",
            "telephone_number": "610-402-7632",
            "fax_number": "610-402-7600"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "25 Pocono Rd",
            "address_purpose": "LOCATION",
            "city": "Denville",
            "state": "NJ",
            "postal_code": "078342954",
            "country_code": "US",
            "telephone_number": "973-595-0600",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "25 Pocono Rd",
            "address_purpose": "LOCATION",
            "city": "Denville",
            "state": "NJ",
            "postal_code": "078342954",
            "country_code": "US",
            "telephone_number": "973-595-0600",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHOUDRY",
        "first_name": "OMER",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-07-15",
        "last_updated": "2019-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080N0001X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Neonatal-Perinatal Medicine",
            "state": "PA",
            "license": "MD467857",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NJ",
            "license": "25MA08964300",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Allentown, PA

Sources for this page

Verify at the official NPI Registry.