Individual provider Active NPI

Noah Daniel Hurst Lewis, MD

  • Student in an Organized Health Care Education/Training Program
  • Boston, MA
National Provider Identifier
1013700640
Registry record updated May 11, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
License
3017835 Issued in MA
Practice address
55 Fruit St.
Yawhay Outpatient Center -5B
Boston, MA 02114
Phone
(617) 643-7117
Fax
(617) 643-7222
NPI assigned
May 27, 2025
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 11, 2026

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Cardiac Electrophysiology Physician 207RC0001X 3017835 MA
Internal Medicine Physician 207R00000X 3017835 MA
Student in an Organized Health Care Education/Training Program 390200000X
Cardiovascular Disease Physician 207RC0000X 3017835 MA
Student in an Organized Health Care Education/Training Program 390200000X 3017835 MA Primary

Addresses

Primary practice location

55 Fruit St.
Yawhay Outpatient Center -5B
Boston, MA 02114

Mailing address

21 Charles St
Apt. 604
Cambridge, MA 02141
Phone (857) 270-4790

Other practice location 1

800 Washington St
Boston, MA 02111-1552
Phone (617) 636-5000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20251126001548 MA Order and Referring Only - Cardiovascular Disease (Cardiology)Practitioner - Cardiovascular Disease (Cardiology) 6608368600
I20260604001930 MA Order and Referring Only - Cardiac ElectrophysiologyPractitioner - Cardiovascular Disease (Cardiology)Practitioner - Cardiac ElectrophysiologyPractitioner - Internal Medicine 6608368600

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
3017835MAMDInternal Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1748304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1778457600000",
    "number": "1013700640",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21 CHARLES ST",
            "address_2": "APT. 604",
            "city": "CAMBRIDGE",
            "state": "MA",
            "postal_code": "02141",
            "telephone_number": "857-270-4790",
            "fax_number": "956-625-5591"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 FRUIT ST.",
            "address_2": "YAWHAY OUTPATIENT CENTER -5B",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "02114",
            "telephone_number": "617-643-7117",
            "fax_number": "617-643-7222"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "800 Washington St",
            "address_purpose": "LOCATION",
            "city": "Boston",
            "state": "MA",
            "postal_code": "021111552",
            "country_code": "US",
            "telephone_number": "617-636-5000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEWIS",
        "first_name": "NOAH",
        "middle_name": "DANIEL HURST",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-05-27",
        "last_updated": "2026-05-11",
        "certification_date": "2026-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Clinical Cardiac Electrophysiology",
            "state": "MA",
            "license": "3017835",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MA",
            "license": "3017835",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "MA",
            "license": "3017835",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "MA",
            "license": "3017835",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.