Individual provider Active NPI

Michael Giacoumopoulos

  • Physician Assistant
  • Allentown, PA
National Provider Identifier
1972110658
Registry record updated Feb 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
3131 College Heights Blvd Ste 2200
Allentown, PA 18104-4877
Phone
(610) 433-8615
NPI assigned
Sep 28, 2020
Last updated
Feb 23, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 23, 2021

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 PA Primary

Addresses

Primary practice location

3131 College Heights Blvd Ste 2200
Allentown, PA 18104-4877

Mailing address

1605 N Cedar Crest Blvd Ste 110B
Allentown, PA 18104-2351
Phone (610) 973-1410

Other practice location 1

4955 Route 873 Ste B
Schnecksville, PA 18078-2265
Phone (610) 799-4100

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
I20210302002204 PA Practitioner - Physician Assistant 9436565231 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
Group practices
Lehigh Valley Physician GroupGroup PAC ID 3072425123, 2,512 clinicians

Practice addresses (Care Compare)

2100 Mack Blvd
FL 4
Allentown, PA 18103-5622

281 N 12TH St
LVPG Vascular Surgery
Lehighton, PA 18235-1101
Phone (610) 402-9400

281 N 12TH St B
Lehighton, PA 18235-1101
Phone (610) 377-7793

281 N 12TH St F
LVPG Obstetrics and Gynecology
Lehighton, PA 18235-1101
Phone (610) 377-5959

4955 Route 873
Suite B
Schnecksville, PA 18078-2265
Phone (610) 799-4100

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Lehigh Valley Physician Group CurrentSince Mar 15, 2021 Accepting new patients
Lehigh Valley Physician Group CurrentSince Mar 15, 2021 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

1605 N Cedar Crest Blvd
Ste 110B
Allentown, PA 18104
Phone (610) 973-1410

2100 Mack Blvd
Fl 4
Allentown, PA 18103

3131 College Heights Blvd
Allentown, PA 18104
Phone (610) 439-8551

3131 College Heights Blvd
Ste 2200
Allentown, PA 18104
Phone (610) 433-8615

281 N 12th St
Ste B
Lehighton, PA 18235
Phone (610) 377-7793

4955 Route 873
Ste B
Schnecksville, PA 18078
Phone (610) 799-4100

Interoperability endpoints

  • Direct secure messaging: michael.giacoumopoulospac.p1@direct.secureehr.nextgenshare.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 7

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": "1601251200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614038400000",
    "number": "1972110658",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1605 N CEDAR CREST BLVD STE 110B",
            "city": "ALLENTOWN",
            "state": "PA",
            "postal_code": "181042351",
            "telephone_number": "610-973-1410",
            "fax_number": "610-973-1449"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3131 COLLEGE HEIGHTS BLVD STE 2200",
            "city": "ALLENTOWN",
            "state": "PA",
            "postal_code": "181044877",
            "telephone_number": "610-433-8615"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4955 Route 873 Ste B",
            "address_purpose": "LOCATION",
            "city": "Schnecksville",
            "state": "PA",
            "postal_code": "180782265",
            "country_code": "US",
            "telephone_number": "610-799-4100",
            "fax_number": "610-799-4101",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GIACOUMOPOULOS",
        "first_name": "MICHAEL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-09-28",
        "last_updated": "2021-02-23",
        "certification_date": "2021-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Allentown, PA

Sources for this page

Verify at the official NPI Registry.