Active NPI
Juan R Lewis, M.D.
- Family Medicine Physician
- Minneapolis, MN
National Provider Identifier
1033164165
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 10122
- Practice address
- 1801 Nicollet Ave
Ste 101
Minneapolis, MN 55403-3791 - Phone
- (612) 823-2947
- Fax
- (612) 870-2947
- NPI assigned
- May 24, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 10122 | ND | Primary |
Addresses
Primary practice location
1801 Nicollet Ave
Ste 101
Minneapolis, MN 55403-3791
Mailing address
1801 Nicollet Ave
Ste 101
Minneapolis, MN 55403-3791
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MN
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20060608000203 | MN | Practitioner - Family Practice | 4385663624 |
Care Compare profile
Medicare Care Compare- Specialty
- Family Practice
- Education
- University of Texas Medical Branch at Galveston, 1998
- Medicare assignment
- May accept Medicare assignment
- Group practices
- Universal Medical Services, Inc
Practice addresses (Care Compare)
1801 Nicollet Ave
Minneapolis, MN 55403-3791
Phone (612) 823-2947
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- HHS exclusion list flag
- Flagged The directory lists this NPI on an HHS exclusion list.
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 10122 | ND | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Urgent Care Doctors Office, PA | Family Medicine | Past | Accepting new patients |
| Sama Healthcare | Family Medicine | Past | Accepting new patients |
Interoperability endpoints
- https://fhir4.healow.com/fhir/r4/BFJEAD/Endpoint/BFJEAD
- https://api.platform.athenahealth.com/19405/brand/1/csg/1/fhir/r4
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 and National Provider Directory roles.
-
- Family Medicine Physician
- Minneapolis, MN
- NPI 1376906388
-
- Family Medicine Physician
- Eden Prairie, MN
- NPI 1447204433
Hospital & facility affiliations 23
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Obesity Medicine (Family Medicine) Physician
- Minneapolis, MN
- NPI 1154684835
Hospital
-
- Physical Medicine & Rehabilitation Physician
- Minneapolis, MN
- NPI 1275577215
Hospital
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1148428800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1609891200000",
"number": "1033164165",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1801 NICOLLET AVE",
"address_2": "STE 101",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "554033791"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1801 NICOLLET AVE",
"address_2": "STE 101",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "554033791",
"telephone_number": "612-823-2947",
"fax_number": "612-870-2947"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEWIS",
"first_name": "JUAN",
"middle_name": "R",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-05-24",
"last_updated": "2021-01-06",
"certification_date": "2021-01-06",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "ND",
"license": "10122",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Minneapolis, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2021; 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.
- 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.