Individual provider Active NPI

Suzette Lewis, PSY. D.

  • Clinical Psychologist
  • Anchorage, AK
National Provider Identifier
1013320829
Registry record updated Aug 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
109776 Issued in AK
Practice address
2121 Abbott Rd
Anchorage, AK 99507-4450
Phone
(907) 522-7080
Fax
(907) 522-7088
NPI assigned
Jun 9, 2014
Last updated
Aug 7, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 7, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 109776 AK
Clinical Psychologist 103TC0700X 109776 AK Primary

Addresses

Primary practice location

2121 Abbott Rd
Anchorage, AK 99507-4450

Mailing address

2121 Abbott Rd
Anchorage, AK 99507-4450
Phone (907) 522-7080

Other practice location 1

1825 Academy Dr
Anchorage, AK 99507-5391
Phone (907) 522-7080

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AK
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170117002055 AK Practitioner - Clinical Psychologist 9234411703 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Christian Health AssociatesGroup PAC ID 7517950686, 12 clinicians

Practice addresses (Care Compare)

2121 Abbott Rd
Suite 202
Anchorage, AK 99507-4450
Phone (907) 522-7090

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Christian Health Associates Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1402272000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722988800000",
    "number": "1013320829",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2121 ABBOTT RD",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995074450",
            "telephone_number": "907-522-7080",
            "fax_number": "907-522-7088"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2121 ABBOTT RD",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995074450",
            "telephone_number": "907-522-7080",
            "fax_number": "907-522-7088"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1825 Academy Dr",
            "address_purpose": "LOCATION",
            "city": "Anchorage",
            "state": "AK",
            "postal_code": "995075391",
            "country_code": "US",
            "telephone_number": "907-522-7080",
            "fax_number": "907-522-7088",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEWIS",
        "first_name": "SUZETTE",
        "credential": "PSY. D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-06-09",
        "last_updated": "2024-08-07",
        "certification_date": "2024-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "AK",
            "license": "109776",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "AK",
            "license": "109776",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Anchorage, AK

Sources for this page

Verify at the official NPI Registry.