ST. LUKE'S PHYSICIAN GROUP, INC. (NPI# 1134754930) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1134754930 |
| Entity Type | Organization |
| Organization Name | ST. LUKE'S PHYSICIAN GROUP, INC. |
| Practice Address |
381 Washington Blvd Bangor PA 18013-2745 |
| Mailing Address |
77 S Commerce Way Bethlehem PA 18017-8891 |
| Practice Telephone | 4845262400 |
| Mailing Telephone | 4845268046 |
| Enumeration Date | 2020-03-12 |
| Last Update Date | 2020-03-12 |
| 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 | 2084P0800X |
Psychiatry & Neurology Specialization: Psychiatry |
Allopathic & Osteopathic Physicians | ||
| N | 2084P0804X |
Psychiatry & Neurology Specialization: Child & Adolescent 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 - Bangor ASD Washington Elementary | 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 |
381 WASHINGTON BLVD |
| City | BANGOR |
| State | PA |
| Zip Code | 18013-2745 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790346906 | Colonial Intermediate Unit 20 | Clinic/Center | 381 Washington Blvd, Bangor, PA 18013-2745 | 2019-06-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104298140 | Blue Valley Vision LLC | Eyewear Supplier (Equipment, not the service) | 455 Blue Valley Dr, Bangor, PA 18013 | 2015-10-29 |
| 1588064554 | Roxanne Decesare | Reflexologist | 429 South First St, Bangor, PA 18013 | 2014-08-27 |
| 1467781708 | Shadys Rest | Preferred Provider Organization | 1004 W Juniata Street, Allentown, PA 18013 | 2009-12-16 |
| 1912911371 | Richard J Weaver | Chiropractor | 83 Bangor Junction Road, Blue Valley Plaza, Bangor, PA 18013 | 2006-07-28 |
| 1104373265 | Heavenly Vision | Technician/Technologist | 455 Blue Valley Dr, Bangor, PA 18013 | 2016-09-07 |
| 1881059293 | Timothy James Velekei Sr. | Technician/Technologist | 455 Blue Valley Dr, Bangor, PA 18013 | 2015-12-30 |
| 1629492608 | Elizabeth Kostura | Counselor | 51 Market Street, Bangor, PA 18013 | 2014-02-11 |
| 1518261593 | Carol Augusta Olzinski | Social Worker | 51 Market Street, Bangor, PA 18013 | 2011-01-05 |
| 1073846390 | Christa Robinson | Specialist/Technologist | 19 Columbus St, Apt 3, Roseto, PA 18013 | 2009-09-18 |
| 1326096587 | Matthew Nicholas Sabatine Jr. | Dentist | 137 Broadway, Bangor, PA 18013 | 2006-05-04 |
| Find all providers in zip 18013 | ||||
| Taxonomy Code | 261QM0801X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Mental Health (Including Community Mental Health Center) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881831329 | Wings for Children and Families Inc. | Clinic/Center | 900 Hammond St, Suite 915, Bangor, ME 04401-4378 | 2009-01-20 |
| 1871847103 | Restoration Health LLC | Clinic/Center | 1 Cumberland Pl, Suite 114, Bangor, ME 04401-5083 | 2012-11-08 |
| 1760497200 | Manna Inc | Clinic/Center | 629 Main St, Bangor, ME 04401-6848 | 2006-07-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205437092 | Northeast Counseling Service | Clinic/Center | 109 W Green St, Nanticoke, PA 18634-2212 | 2020-11-06 |
| 1356949663 | Christina Robidoux, Lpc | Clinic/Center | 321 Pine St Ste 207-208, Williamsport, PA 17701-6561 | 2020-10-09 |
| 1447857800 | Simple Healing LLC | Clinic/Center | 11 W 2nd St Unit 305, Bethlehem, PA 18015-1294 | 2020-10-07 |
| 1629683693 | Sunshine Counseling, LLC | Clinic/Center | 1093 Douglass Dr Apt A, Boyertown, PA 19512-7620 | 2020-09-15 |
| 1619582533 | Concern-professional Services for Children, Youth & Families | Clinic/Center | 749 South St, Laporte, PA 18626-7019 | 2020-09-09 |
| 1023623956 | Sunshine Healing & Counseling | Clinic/Center | 328 Summit Ave Ste 120, Jenkintown, PA 19046-3134 | 2020-09-08 |
| 1376153940 | Nami Erie County Pa | Clinic/Center | 1611 Peach St Ste 218, Erie, PA 16501-2121 | 2020-08-07 |
| 1376161919 | Bryan Bass-riley Licensed Professional Counselor, LLC | Clinic/Center | 3825 Northern Pike Ste 202, Monroeville, PA 15146-2161 | 2020-07-09 |
| 1053937664 | Theosis Therapeutic Counseling | Clinic/Center | 982 E Pine St, Palmyra, PA 17078-2821 | 2020-06-19 |
| 1366065633 | Let's Talk Counseling, LLC | Clinic/Center | 510 Springfield Rd, Aldan, PA 19018-4227 | 2020-05-21 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on ST. LUKE'S PHYSICIAN GROUP, INC..
| 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.