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Deactivated NPI 1730139379 Deactivated / Inactive NPI Male Practitioner

Dr. Theodore Kowalyshyn , MD

Internal Medicine • Bethlehem, PA

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Dr. Theodore Kowalyshyn has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date May 12, 2006
NPI Deactivation Date September 30, 2019
Total Practice Duration ~13 Years of Practice (2006 – 2019)

Professional Overview & Biography Verified Profile Summary

Dr. Theodore Kowalyshyn, MD was a registered Internal Medicine practicing in Bethlehem, PA. Throughout an active medical career spanning 13 years, Dr. Kowalyshyn provided care at the practice location at 2101 EMRICK BLVD until profile deactivation on 2019-09-30.

Historical Medicare Part B clinical services included initial nursing facility care with moderate level of medical decision making, per day, if using time, at least, subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least, established patient outpatient office visit. Public procedure reimbursement records and service volume details are provided below for historical transparency.

Practice Location & Contact Primary Location

Practice Address

2101 Emrick Blvd
Suite 100

Bethlehem, PA 180208040

Telephone 6108684000
Fax 6108684033
Associated Practice Facility / Clinic
🏢 Lvpg Healthspring Facility NPI 1063584308

Specialty Benchmarks & Practice Insights

Comparative analytics for Internal Medicine in Bethlehem, PA

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 18.9 Yrs
State Avg: 28.2 Yrs
Regional Practice Density
161 Specialists

Practicing in Bethlehem, PA (7609 Statewide)

Telehealth Adoption Rate
18.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
48.0% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2018)
Reporting Year:
HCPCS Code & Description Services Patients Submitted Charge Medicare Allowed
99305 Initial nursing facility care with moderate level of medical decision making, per day, if using time, at least 35 minutes
24 23 $250.00 $128.32
99309 Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes
18 13 $170.00 $89.87

Medical Specialties & State Licenses

Internal Medicine Primary Specialty

NUCC Taxonomy Code: 207R00000X

State License PA MD009633E

A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

11 Associated Practitioners
Morgan Vizzoni , PA-C

Physician Assistant - Medical

NPI 1073058848

Physician Assistant (Certified)

NPI 1124292552

Doctor of Osteopathic Medicine (D.O.)

Dr. Wayne Fellows , DO

Family Medicine

NPI 1265869952

Doctor of Osteopathic Medicine (D.O.)

Dr. Raji Mathew , MD

Family Medicine

NPI 1316262025

Doctor of Medicine (M.D.)

NPI 1336146224

Doctor of Osteopathic Medicine (D.O.), FACP

Jeremy Griffis , PA-C

Physician Assistant

NPI 1417466269

Physician Assistant (Certified)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events
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NPI Profile Deactivated September 30, 2019

Record deactivated on September 30, 2019

NPI Profile Active October 05, 2016

NPI status registered as active in NPPES database

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Updated Practice Location October 05, 2016

Registered at 2101 EMRICK BLVD, SUITE 100, BETHLEHEM, PA 180208040 (Tel: 6108684000)

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Updated Business Mailing Address October 05, 2016

Registered at PO BOX 783311, PHILADELPHIA, PA 191783311 (Tel: 4848844500)

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Provider Name / Credentials Updated October 05, 2016

Recorded as THEODORE KOWALYSHYN, MD

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Medical Taxonomy / Specialty Registered (Primary Specialty) October 05, 2016

Internal Medicine (License #MD009633E in PA)

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Initial NPI Registration & Enumeration May 12, 2006

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1730139379
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: May 12, 2006
Last Update: October 05, 2016
Deactivation Date: September 30, 2019

Mailing Address

Po Box 783311

Philadelphia, PA 191783311

Phone: 4848844500

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.