Heather Lewis

Individual provider Active NPI Physical Therapist · Wenham, MA

NPI 1013453992 · NPPES record last updated Jan 16, 2017

Key facts

NPI
1013453992
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapist 225100000X
License
13395 (MA)
Practice address
255 Grapevine Rd
Wenham, MA 01984-1813
Phone
(978) 867-4095
NPI assigned
Jan 16, 2017
Sex
Female
Sole proprietor
No

Organizations & group practices 1

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

Medicare Care Compare profile

Specialty
Physical Therapist in Private Practice
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Gordon College (11 clinicians)

Practice addresses (Care Compare)

255 Grapevine Rd
Wenham, MA 01984-1813
Phone (978) 867-4095

Medicare participation

Medicare fee-for-service enrollment
Enrolled in MA

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20170302001017 MA Practitioner - Physical Therapist in Private Practice 0648554014 Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD)
Yes

Practice roles

OrganizationSpecialtyStatusNew patients
Gordon College Physical Therapist Current
since Jan 17, 2017
Accepting new patients

Locations

255 Grapevine Rd
Wenham, MA 01984
Phone (978) 524-0000

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 13395 MA Yes

Addresses

Primary practice location

255 Grapevine Rd
Wenham, MA 01984-1813

Mailing address

255 Grapevine Rd
Wenham, MA 01984-1813
Phone (978) 867-4095

Other providers in Wenham, MA

All providers in Wenham, MA · Physical Therapist in Massachusetts

Sources for this page

Verify at the official NPI Registry.