| Bryan Ebert, MD | |
|
3805 W Chester Pike, Building D, Suite 120, Newtown Square, PA 19073-2329 | |
| (610) 550-3000 | |
| (610) 550-3079 |
| Full Name | Bryan Ebert |
|---|---|
| Gender | Male |
| Speciality | Pathology |
| Experience | 22 Years |
| Location | 3805 W Chester Pike, Newtown Square, Pennsylvania |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1871716092 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207ZP0101X | Pathology - Anatomic Pathology | 235059-1 (New York) | Secondary |
| 207ZD0900X | Pathology - Dermatopathology | 235059 (New York) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| St Luke's Hospital Bethlehem | Bethlehem, PA | Hospital |
| St Luke's Hospital - Anderson Campus | Easton, PA | Hospital |
| Lehigh Valley Hospital | Allentown, PA | Hospital |
| St Luke's Hospital - Monroe Campus | Stroudsburg, PA | Hospital |
| St Luke's Warren Hospital | Phillipsburg, NJ | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| St Lukes Physician Group Inc | 6709798333 | 1858 |
| Gslpg, Inc | 7810226875 | 201 |
| St Lukes Warren Physician Group Pc | 9739093675 | 312 |
| Entity Name | St Lukes Physician Group Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1700984622 PECOS PAC ID: 6709798333 Enrollment ID: O20040226000062 |
| Entity Name | Gslpg, Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1366006702 PECOS PAC ID: 7810226875 Enrollment ID: O20190917001763 |
| Mailing Address | Practice Location Address |
|---|---|
| Bryan Ebert, MD 3805 W Chester Pike, Building D, Suite 120, Newtown Square, PA 19073-2329 Ph: (610) 550-3000 | Bryan Ebert, MD 3805 W Chester Pike, Building D, Suite 120, Newtown Square, PA 19073-2329 Ph: (610) 550-3000 |
Dr. Ann Minehan Ainsworth, M.D. Pathology Medicare: Not Enrolled in Medicare Practice Location: 35 Horseshoe Ln, Newtown Square, PA 19073 Phone: 610-353-8679 | |
Katrin Kiavash, M.D. Pathology Medicare: Medicare Enrolled Practice Location: 3805 W Chester Pike Ste 120, Newtown Square, PA 19073 Phone: 800-257-0117 | |
Albert A Keshgegian, M.D. Pathology Medicare: Not Enrolled in Medicare Practice Location: 45 Sugar Maple Dr, Newtown Square, PA 19073 Phone: 610-573-3746 | |
Dr. Susanne Nussen Lee, MD Pathology Medicare: Medicare Enrolled Practice Location: 3805 W Chester Pike Bldg D, Suite 120, Newtown Square, PA 19073 Phone: 800-257-0117 Fax: 610-550-3079 | |
Dr. Lawrence David Hall, M.D. Pathology Medicare: Not Enrolled in Medicare Practice Location: 3805 W Chester Pike, Bldg D, Suite 120, Newtown Square, PA 19073 Phone: 800-257-0117 Fax: 610-550-3079 | |
Mary Katherine Mcgonagle, D.O. Pathology Medicare: Medicare Enrolled Practice Location: 3805 W Chester Pike, Bldg D, Suite 120, Newtown Square, PA 19073 Phone: 800-257-0117 Fax: 610-550-3079 |