ST. LUKE'S PHYSICIAN GROUP, INC. (NPI# 1124653431) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1124653431 |
| Entity Type | Organization |
| Organization Name | ST. LUKE'S PHYSICIAN GROUP, INC. |
| Practice Address |
1619 Laubach Ave Northampton PA 18067-1517 |
| Mailing Address |
77 S Commerce Way Bethlehem PA 18017-8891 |
| Practice Telephone | 4845262400 |
| Mailing Telephone | 4845268046 |
| Enumeration Date | 2020-03-06 |
| Last Update Date | 2020-03-06 |
| Authorized Official Name | SUE CHIAVAROLI (CVO ENROLLMENT SUPERVISOR) |
| Authorized Official Telephone | 4845263569 |
| Is Organization Subpart | Y |
| Parent Organization Name | ST. LUKE'S PHYSICIAN GROUP, INC. |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 2084P0804X |
Psychiatry & Neurology Specialization: Child & Adolescent Psychiatry |
Allopathic & Osteopathic Physicians | ||
| N | 2084P0800X |
Psychiatry & Neurology Specialization: Psychiatry |
Allopathic & Osteopathic Physicians | ||
| Y | 261QM0801X |
Clinic/Center Specialization: Mental Health (Including Community Mental Health Center) |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| St. Luke's Psychiatric Associates - Northampton ASD High School | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225645518 | St. Luke's Physician Group, Inc. | Psychiatry & Neurology | 723 Coal St, Easton, PA 18042-6556 | 2020-09-30 |
| 1093322380 | St. Luke's Physician Group, Inc. | Psychiatry & Neurology | 990 Echo Trl, Easton, PA 18040-1014 | 2020-09-30 |
| 1720695141 | St. Luke's Physician Group, Inc. | Psychiatry & Neurology | 429 Reeder St, Easton, PA 18042-1731 | 2020-09-29 |
| 1710594130 | St. Luke's Physician Group, Inc. | Psychiatry & Neurology | 1709 Richmond Rd, Easton, PA 18040-8435 | 2020-09-29 |
| 1528675345 | St. Luke's Physician Group, Inc. | Psychiatry & Neurology | 1315 Echo Trl, Easton, PA 18040-1019 | 2020-09-25 |
| 1164039996 | St. Luke's Physician Group, Inc. | Psychiatry & Neurology | 1243 Tatamy Rd, Easton, PA 18045-7405 | 2020-09-25 |
| 1578170304 | St. Luke's Physician Group, Inc. | Psychiatry & Neurology | 1221 Northampton St, Easton, PA 18042-4138 | 2020-09-25 |
| 1144834649 | St. Luke's Physician Group, Inc. | Psychiatry & Neurology | 257 Brodhead Rd, Bethlehem, PA 18017-8938 | 2020-09-02 |
| 1689288110 | St. Luke's Physician Group, Inc. | Psychiatry & Neurology | 1021 Calypso Ave, Bethlehem, PA 18018-5005 | 2020-09-02 |
| 1962016477 | St. Luke's Physician Group, Inc. | Psychiatry & Neurology | 1621 Catasauqua Rd, Bethlehem, PA 18017-7407 | 2020-09-02 |
| Street Address |
1619 LAUBACH AVE |
| City | NORTHAMPTON |
| State | PA |
| Zip Code | 18067-1517 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265966915 | Jorge Perez | Specialist/Technologist | 1619 Laubach Ave, Northampton, PA 18067-1517 | 2017-04-19 |
| 1619404712 | Jessica Frontanes Pagan | Specialist/Technologist | 1619 Laubach Ave, Northampton, PA 18067-1517 | 2017-05-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639666829 | St. Luke's Physician Group, Inc. | Family Medicine | 602b East 21st St, Suite 400, Northampton, PA 18067 | 2018-04-13 |
| 1720444722 | Josiely Garcia | Behavioral Analyst | 1325 Granger Rd, Northampton, PA 18067 | 2016-01-06 |
| 1801153143 | Lehigh Valley Dental Solutions | Dentist | 3258 Cherryville Rd., Northampton, PA 18067 | 2012-04-11 |
| 1578715694 | Dawn Marie Newhard-vilanova | Occupational Therapist | 445 Indian Trail Rd., Northampton, PA 18067 | 2008-10-21 |
| 1326205170 | Pennsylvania Assessment Consultants for Co Occurring Disorders LLC | Counselor | 2030 Center St. Plaza, Suite 104, Northampton, Pa 18067, PA 18067 | 2008-05-20 |
| 1972706091 | Wassim Abosamra | Family Medicine | 602 East 21st Street, Northampton, PA 18067 | 2007-06-06 |
| 1568683167 | Craig Rice | Physical Therapist | 818 Ward Drive, Northampton, PA 18067 | 2007-05-01 |
| 1114054459 | Sarah F Hilbert | Physician Assistant | 602b East 21st Street, Suite 400, Northampton, PA 18067 | 2007-02-27 |
| 1669583159 | Daniel Joseph Milavec | Dentist | 1855 Washington Ave, Northampton, PA 18067 | 2006-08-31 |
| 1881653657 | Junaid Sultan | Internal Medicine | 602 B East 21st Street, Suite 400, Northampton, PA 18067 | 2006-03-21 |
| Find all providers in zip 18067 | ||||
| Taxonomy Code | 261QM0801X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Mental Health (Including Community Mental Health Center) |
| Definition to come... |
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| 1518261874 | Glenn S. Fagen Phd Inc | Clinic/Center | 100 King St, Suite 303, Northampton, MA 01060-3243 | 2010-12-30 |
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| Find all providers with the same taxonomy | ||||
| City | NORTHAMPTON |
| Zip Code | 18067 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.