1. Home
  2. Directory
  3. Pennsylvania
  4. Wind Gap
  5. Family Medicine
  6. NPI Profile

BUSHKILL FAMILY PRACTICE
NPI 1063463701
Family Medicine in Wind Gap, PA

Active since May 15, 2006CLIA 39D0896604 · Waiver
497 BUSHKILL PLAZA LN, WIND GAP, PA 18091(610) 863-7020(866) 833-9399 Get Directions Write a Review

NPPES record last updated: October 11, 2022. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Oct 11, 2022, Jan 17, 2018 (2 updates tracked since 2018).

About Bushkill Family Practice NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

BUSHKILL FAMILY PRACTICE (NPI 1063463701) is a healthcare organization registered as a family medicine in Wind Gap, Pennsylvania and active in the NPI registry since May 2006. The organization holds a CLIA Waiver certificate valid through January 12, 2027 and lists Susan Chiavaroli, Manager, as its authorized official.

NPPES Registry Identity

NPI1063463701
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameST. LUKE'S PHYSICIAN GROUP, INC.
Location Address497 BUSHKILL PLAZA LNWind Gap, PA 18091-9665
Mailing Address801 Ostrum StBethlehem, PA 18015-1000 · (610) 863-7020 · Fax (866) 833-9399
Phone(610) 863-7020
Fax(866) 833-9399
Organization SubpartNo
Authorized OfficialSusan ChiavaroliManager · (484) 526-3569
Enumeration DateMay 15, 2006
Last NPPES UpdateOctober 11, 20222 updates tracked since enumeration
NPPES CertifiedOctober 11, 2022
✔ NPI 1063463701 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
497 BUSHKILL PLAZA LN, Wind Gap, PA 18091
Open in Google Maps ↗

Other Names 1

Doing Business AsBushkill Family Practice

Other Identifiers 1

Medicaid1007307530018PA

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 39D0896604

Bushkill Family Practice · Wind Gap, PA
Active · expires Jan 12, 2027
CLIA Number39D0896604
Laboratory TypePhysician Office
Certificate Effective DateJanuary 13, 2025
Certificate Expiration DateJanuary 12, 2027
Laboratory DirectorDr. Ellen M. Didimamoff
Laboratory Phone(484) 503-2055
Laboratory LocationBushkill Family Practice487 Moorestown Rd Suite 110, Wind Gap, PA 18091
CLIA data matches this NPI record on: Name
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

ALBERT B DEFRANCO MD
Family Medicine
497 BUSHKILL PLAZA LN
WIND GAP, PA 18091
Northampton County (610) 863-7020
ELLEN MARIE DIDIMAMOFF MD
Family Medicine
497 BUSHKILL PLAZA LN
WIND GAP, PA 18091
Northampton County (610) 863-7020

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is St. Luke's Physician Group, Inc.'s NPI number?

The NPI number for St. Luke's Physician Group, Inc. is 1063463701. It was assigned to this organization in the NPPES registry on May 15, 2006. The provider is doing business as Bushkill Family Practice.

Where is St. Luke's Physician Group, Inc. located?

St. Luke's Physician Group, Inc. is located at 497 Bushkill Plaza Ln, Wind Gap, PA 18091. The listed phone number is (610) 863-7020.

What is St. Luke's Physician Group, Inc.'s specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Does St. Luke's Physician Group, Inc. hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 39D0896604) is associated with this NPI, valid through January 12, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for St. Luke's Physician Group, Inc. was last updated on October 11, 2022. NPI Profile syncs with the weekly NPPES data releases published by CMS.