Individual provider Active NPI

Constance Jie Lew, OTD

  • Occupational Therapist
  • West Covina, CA
National Provider Identifier
1023738564
Registry record updated Apr 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
Practice address
100 N Barranca St Ste 380
West Covina, CA 91791-1652
Phone
(626) 331-8355
Fax
(626) 331-8165
NPI assigned
Sep 2, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X Primary

Addresses

Primary practice location

100 N Barranca St Ste 380
West Covina, CA 91791-1652

Mailing address

1845 Business Center Dr Ste 127
San Bernardino, CA 92408-3434
Phone (909) 890-9030

Other practice location 1

10470 Foothill Blvd Ste 101
Rancho Cucamonga, CA 91730-3754
Phone (909) 948-0411

Other identifiers 1

IdentifierTypeStateIssuer
1023738564MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230131000757 CA Practitioner - Occupational Therapist in Private Practice 2860863859 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2021
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1845 Business Ctr Dr
Suite 127
San Bernardino, CA 92408

18805 Ashley PL
Rowland Heights, CA 91748-4870

2600 Dallas Pkwy
Suite 290
Frisco, TX 75034-7486

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
United Therapy Network Incorporated Occupational Therapist CurrentSince Jan 9, 2023 Accepting new patients
United Therapy Network Incorporated Occupational Therapist CurrentSince Jan 9, 2023 Accepting new patients
United Therapy Network Incorporated Occupational Therapist Current Accepting new patients

Locations

802 Magnolia Ave
Ste 107
Corona, CA 92879
Phone (951) 340-0070

1902 Royalty Dr
Ste 220
Pomona, CA 91767
Phone (909) 570-3108

10470 Foothill Blvd
Ste 101
Rancho Cucamonga, CA 91730
Phone (909) 948-0411

1845 Business Center Dr
Ste 127
Sn Bernrdno, CA 92408
Phone (909) 890-9030

100 N Barranca St
Ste 380
West Covina, CA 91791
Phone (626) 331-8355

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1662076800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714348800000",
    "number": "1023738564",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1845 BUSINESS CENTER DR STE 127",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924083434",
            "telephone_number": "909-890-9030",
            "fax_number": "909-890-4393"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 N BARRANCA ST STE 380",
            "city": "WEST COVINA",
            "state": "CA",
            "postal_code": "917911652",
            "telephone_number": "626-331-8355",
            "fax_number": "626-331-8165"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10470 Foothill Blvd Ste 101",
            "address_purpose": "LOCATION",
            "city": "Rancho Cucamonga",
            "state": "CA",
            "postal_code": "917303754",
            "country_code": "US",
            "telephone_number": "909-948-0411",
            "fax_number": "909-890-4393",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEW",
        "first_name": "CONSTANCE",
        "middle_name": "JIE",
        "credential": "OTD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-09-02",
        "last_updated": "2024-04-29",
        "certification_date": "2024-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1023738564",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in West Covina, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.