Kirk J Lewis, MD

Primary specialty

Sports Medicine (Orthopaedic Surgery) PhysicianTaxonomy code 207XX0005X

License

M4960 Issued in ID

Practice address

1188 University Dr
Boise, ID 83706

Phone

(208) 336-8250

Fax

(208) 345-9514

NPI assigned

Jun 24, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in ID, CA2 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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: klewis590472@direct.ochin.org

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.

• Regents of the Univ of Ca

  • Maternal & Fetal Medicine Physician
  • Sacramento, CA
  • NPI 1013906973
  Medicare reassignment NPD
• Idaho Sports Medicine Institute PA

  • Sports Medicine (Neuromusculoskeletal Medicine) Physician
  • Boise, ID
  • NPI 1154356624
  Medicare reassignment
• Regents of the Univ of Ca

  • Pediatric Cardiology Physician
  • Sacramento, CA
  • NPI 1144213166
  NPD
• Regents of the Univ of Ca

  • Diagnostic Radiology Physician
  • Sacramento, CA
  • NPI 1477546406
  NPD

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

{
    "created_epoch": "1119571200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1534377600000",
    "number": "1033115803",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1188 W UNIVERSITY DR",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837063009",
            "telephone_number": "208-336-8250",
            "fax_number": "208-345-9514"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1188 UNIVERSITY DR",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "83706",
            "telephone_number": "208-336-8250",
            "fax_number": "208-345-9514"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEWIS",
        "first_name": "KIRK",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-24",
        "last_updated": "2018-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207XX0005X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": "ID",
            "license": "M4960",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1033115803",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• George H Lewis, DDS
• Janee Lewis
• Jennifer Kathryn Lewis, MD
• Jennifer Ritz Lewis, DNP, FNP-BC, AOCNS
• Jodi Lewis, RN
• Madeline Lewis, PA-C
• Scott Ryan Lewis, O.D.
• Stacey Payne Lewis, LCSW
• Vanessa Kay Lewis, MED
• Leyline Advocates, LLC

• Sports Medicine (Orthopaedic Surgery) Physician in Boise, ID
• Providers in Boise, ID by specialty
• Sports Medicine (Orthopaedic Surgery) Physician in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.