NPIMap

Organization Active NPI

Lehigh Valley Physician Group

Doing business as Vibrant Life Primary Care

  • Family Medicine Physician
  • Bethlehem, PA
National Provider Identifier
1942067111
Registry record updated Mar 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
LEHIGH VALLEY PHYSICIAN GROUP
Doing business as
Vibrant Life Primary Care
Practice address
2045 Westgate Dr
Bethlehem, PA 18017-7480
Phone
(610) 849-2059
Fax
(610) 419-0654
NPI assigned
Mar 4, 2024
Last updated
Mar 18, 2025By the provider in NPPES
Organization subpart
Yes
Parent organization
LEHIGH VALLEY PHYSICIAN GROUPAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 18, 2025

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

Authorized official

Name
James Demopoulos
Title
SVP & Cto
Phone
(484) 862-3333

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X NU Primary

Addresses

Primary practice location

2045 Westgate Dr
Bethlehem, PA 18017-7480

Mailing address

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

Other names 1

  • Vibrant Life Primary Care Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040227000335 PA Part B Supplier - Clinic/Group Practice 3072425123 Receives reassigned benefits from 3,502 practitioners
This NPI is an additional NPI on the enrollment

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
39D2301739Vibrant Life Primary Care2045 Westgate Dr, Ste 402, Bethlehem, PA 18017Certificate of waiverMar 31, 2028

National Provider Directory

National Provider Directory
Tax ID family
Lehigh Vly Phy GP168 organizations share this tax ID, including this one
Part of
Lehigh Vly Phy GP

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Locations

2045 Westgate Dr
Ste 402
Bethlehem, PA 18017
Phone (215) 233-5688

Practitioners & affiliated clinicians

Practitioners 2

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": "1709510400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1742256000000",
    "number": "1942067111",
    "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"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2045 WESTGATE DR",
            "city": "BETHLEHEM",
            "state": "PA",
            "postal_code": "180177480",
            "telephone_number": "610-849-2059",
            "fax_number": "610-419-0654"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEHIGH VALLEY PHYSICIAN GROUP",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "LEHIGH VALLEY PHYSICIAN GROUP",
        "enumeration_date": "2024-03-04",
        "last_updated": "2025-03-18",
        "certification_date": "2025-03-18",
        "status": "A",
        "authorized_official_last_name": "DEMOPOULOS",
        "authorized_official_first_name": "JAMES",
        "authorized_official_title_or_position": "SVP & CTO",
        "authorized_official_telephone_number": "484-862-3333"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Vibrant Life Primary Care",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Vibrant Life Primary Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bethlehem, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.