ST. LUKE'S PHYSICIAN GROUP, INC. (NPI# 1538314638) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1538314638 |
| Entity Type | Organization |
| Organization Name | ST. LUKE'S PHYSICIAN GROUP, INC. |
| Other Organization Name | ST. LUKE'S PLASTIC & RECONSTRUCTIVE SURGERY |
| Practice Address |
74 W Broad St Ste 170 Bethlehem PA 18018 |
| Mailing Address |
74 W Broad St Ste 170 Bethlehem PA 18018-5738 |
| Practice Telephone | 4845265277 |
| Practice Fax Number | 8338167511 |
| Mailing Telephone | 4845265277 |
| Mailing Fax Number | 8338167511 |
| Enumeration Date | 2008-11-18 |
| Last Update Date | 2018-05-14 |
| Authorized Official Name | DEAN W. EVANS (PRESIDENT) |
| Authorized Official Telephone | 4845264991 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2086S0122X |
Surgery Specialization: Plastic and Reconstructive Surgery |
Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| St. Luke's Plastic & Reconstructive Surgery | 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 |
74 W BROAD ST STE 170 |
| City | BETHLEHEM |
| State | PA |
| Zip Code | 18018 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124072442 | Joanne P Mulligan | Physician Assistant | 74 W Broad St Ste 170, Bethlehem, PA 18018-5738 | 2006-05-20 |
| 1598051716 | Jonathan Lam | Surgery | 74 W Broad St Ste 170, Bethlehem, PA 18018-5738 | 2011-06-27 |
| 1154589950 | Juan Carlos Martinez Grullon | Plastic Surgery | 74 W Broad St Ste 170, Bethlehem, PA 18018-5738 | 2008-05-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093373292 | Jade Madison Hennessy | Specialist/Technologist | Moravian College, 1200 Main Street, Bethlehem, PA 18018 | 2019-06-03 |
| 1780106179 | Courtney Jane Kruscavage | Specialist/Technologist | 641 Dellwood Street, Bethlehem, PA 18018 | 2017-07-07 |
| 1205357936 | Balanced Body Therapeutic Massage, LLC | Massage Therapist | 227 W Broad St Ste 102, Bethlehem, PA 18018 | 2017-07-03 |
| 1033567599 | Jessamine Martin | Counselor | 1 East Broad Street, Suite 510, Bethlehem, PA 18018 | 2016-05-25 |
| 1841650041 | Akhi Saha | Internal Medicine | 325 W Broad St Fl 1, Bethlehem, PA 18018 | 2016-03-01 |
| 1063804193 | Paul Minh Le | Internal Medicine | 800 Eaton Ave Ste B, Bethlehem, PA 18018 | 2015-02-26 |
| 1578962841 | Elizabeth Veronica Weiss Iobst | Counselor | 1754 W. Broad St., Bethlehem, PA 18018 | 2014-08-22 |
| 1255771739 | Inner Resources Counseling Inc | Counselor | 807 West Broad St, Bethlehem, PA 18018 | 2013-06-28 |
| 1437404878 | St Luke Hospital | General Acute Care Hospital | 1956 C Allwood Dr., Bethlehem, PA 18018 | 2012-07-23 |
| 1275802944 | St. Luke's Physician Group, Inc | Ophthalmology | 800 Eaton Avenue, Suite 101, Bethlehem, PA 18018 | 2011-12-23 |
| Find all providers in zip 18018 | ||||
| Taxonomy Code | 2086S0122X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| Specialization | Plastic and Reconstructive Surgery |
| A surgeon who specializes in plastic and reconstructive surgery. |
| Notes: Source: National Uniform Claim Committee, 2009 [1/1/2010: definition added, source added] Additional Resources: A General Certificate is issued by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598051716 | Jonathan Lam | Surgery | 74 W Broad St Ste 170, Bethlehem, PA 18018-5738 | 2011-06-27 |
| 1164751004 | Lehigh Valley Physician Group | Surgery | 2597 Schoenersville Rd, Suite 305, Bethlehem, PA 18017-7325 | 2009-12-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326698549 | Michael Shafran Do PC | Surgery | 2 Park Ln Fl 3, Feasterville Trevose, PA 19053-6004 | 2019-09-19 |
| 1255873915 | Lam Plastic Surgery LLC | Surgery | 848 Town Center Drive, Langhorne, PA 19047-3439 | 2016-11-12 |
| 1487029971 | Philip Lipkin | Surgery | 233 S 6th St Apt 2101, Philadelphia, PA 19106-3756 | 2015-12-09 |
| 1477865566 | Ralph W Hamilton | Surgery | 847 Willow Valley Lakes Dr, Willow Street, PA 17584-9040 | 2010-07-06 |
| 1770801870 | Irene Teting Ma | Surgery | 3550 Terrace St 664 Scaife Hall, Pittsburgh, PA 15261 | 2010-05-13 |
| 1649408162 | Michael David Lado | Surgery | 1828 Ridgewood Rd, Orwigsburg, PA 17961-9525 | 2009-06-23 |
| 1245490515 | Wellspan Medical Group | Surgery | 50 Wyntre Brooke Dr, York, PA 17403-4535 | 2008-06-11 |
| 1982813853 | Wellington Joseph Davis IIi | Surgery | 1210 S Cedar Crest Blvd Ste 100, Allentown, PA 18103-6229 | 2007-05-21 |
| 1043423502 | James William Slavin | Surgery | 8216 Cedar Rd., Elkins Park, PA 19027-2114 | 2007-05-08 |
| 1467679787 | Amelia Arianne Pare Md PC | Surgery | 123 Hidden Valley Rd, Mc Murray, PA 15317-2603 | 2007-04-19 |
| Find all providers with the same taxonomy | ||||
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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.