Organization Active NPI

Maureen C. Persin DO PC

  • Internal Medicine Physician
  • Bethlehem, PA
National Provider Identifier
1952415010
Registry record updated Jun 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
OS008314L Issued in PA
Legal business name
MAUREEN C. PERSIN DO PC
Practice address
217 W Broad St
Bethlehem, PA 18018-5517
Phone
(610) 866-0466
Fax
(610) 866-1405
NPI assigned
Aug 18, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 28, 2024

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

Authorized official

Name
David Green, RHIT, CCS-P, CAHIMS
Title
Office Manager
Phone
(610) 866-0466

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X OS008314L PA Primary

Addresses

Primary practice location

217 W Broad St
Bethlehem, PA 18018-5517

Mailing address

217 W Broad St
Bethlehem, PA 18018-5517
Phone (610) 866-0466

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040107000104 PA Part B Supplier - Clinic/Group Practice 8729987953 Receives reassigned benefits from 1 practitioner
Practice locations: Bethlehem, PA

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
39D1013959Maureen C Persin DO PC217 West Broad Street, Bethlehem, PA 18018Certificate of waiverJun 22, 2027

National Provider Directory

National Provider Directory

Locations

217 W Broad St
Bethlehem, PA 18018
Phone (610) 866-0466

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/2434/brand/1/csg/1/fhir/r4

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1155859200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1719532800000",
    "number": "1952415010",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "217 W BROAD ST",
            "city": "BETHLEHEM",
            "state": "PA",
            "postal_code": "180185517",
            "telephone_number": "610-866-0466",
            "fax_number": "610-866-1405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "217 W BROAD ST",
            "city": "BETHLEHEM",
            "state": "PA",
            "postal_code": "180185517",
            "telephone_number": "610-866-0466",
            "fax_number": "610-866-1405"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAUREEN C. PERSIN DO PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-18",
        "last_updated": "2024-06-28",
        "certification_date": "2024-06-28",
        "status": "A",
        "authorized_official_last_name": "GREEN",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "610-866-0466",
        "authorized_official_credential": "RHIT, CCS-P, CAHIMS"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "OS008314L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Jun 28, 2024; 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.