NPIMap

Individual provider Active NPI

Robert James O'Donnell Jr., CRNP

  • Gerontology Nurse Practitioner
  • Allentown, PA
National Provider Identifier
1962917120
Registry record updated Nov 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
SP018236 Issued in PA
Practice address
1250 S Cedar Crest Blvd Ste 110
Allentown, PA 18103
Phone
(610) 402-8900
Fax
(610) 402-5656
NPI assigned
Dec 11, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 5, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X SP018236 PA
Gerontology Nurse Practitioner 363LG0600X SP018236 PA Primary

Addresses

Primary practice location

1250 S Cedar Crest Blvd Ste 110
Allentown, PA 18103

Mailing address

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

Other practice location 1

111 S 11th St
Philadelphia, PA 19107-4824
Phone (215) 955-7036

Other practice location 2

111 S 11th St
Philadelphia, PA 19107-4824
Phone (215) 955-7036

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
I20190802001851 PA Practitioner - Nurse Practitioner 5193052892 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
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
Phoenix Rehabilitation and Health Services IncGroup PAC ID 3476464298, shared by 2 NPIs, 2,775 clinicians

Practice addresses (Care Compare)

1250 S Cedar Crest Blvd
110 LVPG Orthopedics and Sports Medicine
Allentown, PA 18103-6224
Phone (610) 402-8900

2000 Westinghouse Dr
Suite 200
Cranberry Township, PA 16066-5238

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
SP018236PAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Lehigh Valley Physician Group CurrentSince Aug 12, 2019 Accepting new patients
Lehigh Valley Physician Group CurrentSince Aug 12, 2019 Accepting new patients
Lehigh Valley Physician Group Nurse Practitioner Current Accepting new patients
Pulmonary Associates PC Past Accepting new patients
Lehigh Valley Physician Group Past Accepting new patients

Locations

1621 N Cedar Crest Blvd
#1
Allentown, PA 18104

1250 S Cedar Crest Blvd
Ste 110
Allentown, PA 18103
Phone (610) 435-1003

2100 Mack Blvd
Fl 4
Allentown, PA 18103

2597 Schoenersville Rd
Ste 100
Bethlehem, PA 18017
Phone (484) 884-2075

111 Switzgabel Dr
Brodheadsville, PA 18322
Phone (570) 369-1004

505 Independence Rd
#1
East Stroudsburg, PA 18301

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

1120 Oak St
Pittston Township, PA 18640
Phone (570) 299-3384

320 W Pumping Station Rd
Quakertown, PA 18951
Phone (215) 529-4240

1411 Jacobsburg Rd
Wind Gap, PA 18091
Phone (484) 861-0493

Interoperability endpoints

  • Direct secure messaging: rodonnell345889@direct2.lvhn.org

Organizations & group practices 6

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 11

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": "1512950400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730764800000",
    "number": "1962917120",
    "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": "1250 S CEDAR CREST BLVD STE 110",
            "city": "ALLENTOWN",
            "state": "PA",
            "postal_code": "18103",
            "telephone_number": "610-402-8900",
            "fax_number": "610-402-5656"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "111 S 11th St",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191074824",
            "country_code": "US",
            "telephone_number": "215-955-7036",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "111 S 11th St",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191074824",
            "country_code": "US",
            "telephone_number": "215-955-7036",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "O'DONNELL",
        "first_name": "ROBERT",
        "middle_name": "JAMES",
        "name_suffix": "Jr.",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-12-11",
        "last_updated": "2024-11-05",
        "certification_date": "2024-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "PA",
            "license": "SP018236",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "PA",
            "license": "SP018236",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Allentown, PA

Sources for this page

Verify at the official NPI Registry.