Individual provider Active NPI

Caitlin Bertucci, PA-C

  • Physician Assistant
  • Allentown, PA
National Provider Identifier
1932702206
Registry record updated Nov 19, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
MA062073 Issued in PA
Practice address
401 N 17TH St Ste 301
Allentown, PA 18104-5051
Phone
(610) 969-3630
NPI assigned
Nov 19, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 19, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X MA062073 PA Primary

Addresses

Primary practice location

401 N 17TH St Ste 301
Allentown, PA 18104-5051

Mailing address

4157 Bunker Hill Dr N
Coopersburg, PA 18036-8818
Phone (908) 202-9600

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20201221000155 PA Practitioner - Physician Assistant 0244642015 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2020
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

1245 S Cedar Crest Blvd
201 LVPG Obstetrics and Gynecology
Allentown, PA 18103-6258
Phone (610) 402-4870

1611 Pond Rd
Allentown, PA 18104-2258

333 Normal Ave
Kutztown, PA 19530-1640

5649 Wynnewood Dr
Laurys Station, PA 18059-1124

Hospital & facility affiliations

  • Lehigh Valley Hospital Hospital, Allentown, PA, CCN 390133

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MA062073PAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Lehigh Valley Physician Group CurrentSince Jan 11, 2021 Accepting new patients
Lehigh Valley Physician Group CurrentSince Jan 11, 2021 Accepting new patients
Pulmonary Associates PC Past Accepting new patients

Locations

401 N 17th St
Ste 301
Allentown, PA 18104
Phone (610) 969-3630

2100 Mack Blvd
Fl 4
Allentown, PA 18103

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

101 W 7th St
Ste 2A
Pennsburg, PA 18073
Phone (215) 257-4866

320 W Pumping Station Rd
Ste 2
Quakertown, PA 18951
Phone (215) 529-4210

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 and National Provider Directory roles.

Hospital & facility affiliations 5

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": "1605744000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605744000000",
    "number": "1932702206",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4157 BUNKER HILL DR N",
            "city": "COOPERSBURG",
            "state": "PA",
            "postal_code": "180368818",
            "telephone_number": "908-202-9600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 N 17TH ST STE 301",
            "city": "ALLENTOWN",
            "state": "PA",
            "postal_code": "181045051",
            "telephone_number": "610-969-3630"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERTUCCI",
        "first_name": "CAITLIN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-11-19",
        "last_updated": "2020-11-19",
        "certification_date": "2020-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA062073",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Allentown, PA

Sources for this page

Verify at the official NPI Registry.