NPIMap

Individual provider Active NPI

Tanveer M Imam, MD

  • Gastroenterology Physician
  • Allentown, PA
National Provider Identifier
1942209697
Registry record updated May 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
MD053040L Issued in PA
Practice address
1501 N Cedar Crest Blvd
Suite 110
Allentown, PA 18104-2309
Phone
(610) 821-2828
Fax
(610) 821-7915
NPI assigned
Jul 15, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 26, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X MD053040L PA Primary

Addresses

Primary practice location

1501 N Cedar Crest Blvd
Suite 110
Allentown, PA 18104-2309

Mailing address

1501 N Cedar Crest Blvd
Suite 110
Allentown, PA 18104-2309
Phone (610) 821-2828

Other identifiers 1

IdentifierTypeStateIssuer
0001855384MedicaidPA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address tanveerimam@epgi.allscriptsdirect.net

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
I20080813000635 PA Practitioner - Gastroenterology 7315977709 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Gastroenterology
Education
Other, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Valley Health Partners Community Health CenterGroup PAC ID 4284065327, shared by 14 NPIs, 121 clinicians
Lehigh Valley Physician GroupGroup PAC ID 3072425123, 2,512 clinicians

Practice addresses (Care Compare)

400 N 17TH St
Allentown, PA 18104-5052

401 N 17TH St
105 LV Specialty Care Physicians Practice
Allentown, PA 18104-5049
Phone (610) 969-4470

Hospital & facility affiliations

  • Lehigh Valley Hospital Hospital, Allentown, PA, CCN 390133
  • Lehigh Valley Hospital - Pocono Hospital, East Stroudsburg, PA, CCN 390201
  • St Lukes Hospital Hospital, Bethlehem, PA, CCN 390049

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy97
Upper gastrointestinal (GI) endoscopy for acid reflux144

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Eastern Pennsylvania Gastroenterology & Liver Specialists P C Gastroenterology CurrentSince Sep 1, 2008 Accepting new patients
Family Care Centers Inc CurrentSince Jan 1, 2021 Accepting new patients
Lehigh Valley Physician Group CurrentSince Dec 11, 2018 Accepting new patients
Family Care Centers Inc. Current Accepting new patients
Lehigh Valley Physician Group Current Accepting new patients
Lehigh Valley Physician Group CurrentSince Dec 11, 2018 Accepting new patients
Pulmonary Associates PC Past Accepting new patients

Locations

401 N 17th St
Ste 207
Allentown, PA 18104
Phone (610) 434-5300

1501 N Cedar Crest Blvd
Ste 110
Allentown, PA 18104
Phone (610) 821-2828

2100 Mack Blvd
Fl 4
Allentown, PA 18103

401 N 17th St
Ste 105
Allentown, PA 18104
Phone (610) 432-2013

175 E Brown St
East Stroudsburg, PA 18301
Phone (570) 421-3401

500 Plaza Ct
Ste A
East Stroudsburg, PA 18301
Phone (570) 424-9970

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

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

Interoperability endpoints

  • Direct secure messaging: timam8628@direct2.lvhn.org

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.

Hospital & facility affiliations 12

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": "1121385600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621987200000",
    "number": "1942209697",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1501 N CEDAR CREST BLVD",
            "address_2": "SUITE 110",
            "city": "ALLENTOWN",
            "state": "PA",
            "postal_code": "181042309",
            "telephone_number": "610-821-2828",
            "fax_number": "610-821-7915"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1501 N CEDAR CREST BLVD",
            "address_2": "SUITE 110",
            "city": "ALLENTOWN",
            "state": "PA",
            "postal_code": "181042309",
            "telephone_number": "610-821-2828",
            "fax_number": "610-821-7915"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IMAM",
        "first_name": "TANVEER",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-15",
        "last_updated": "2021-05-26",
        "certification_date": "2021-05-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "PA",
            "license": "MD053040L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0001855384",
            "state": "PA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tanveerimam@epgi.allscriptsdirect.net",
            "affiliation": "N",
            "address_1": "1501 N Cedar Crest Blvd",
            "address_2": "SUITE 110",
            "city": "Allentown",
            "state": "PA",
            "country_code": "US",
            "postal_code": "181042309",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Allentown, PA

Sources for this page

Verify at the official NPI Registry.