Individual provider Active NPI

Justin Edward Lewis, MD

  • Internal Medicine Physician
  • Gainesville, FL
National Provider Identifier
1053816173
Registry record updated Jun 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
85803 Issued in SC
Practice address
1600 SW Archer Rd Ste 4102
Gainesville, FL 32610-3003
Phone
(352) 265-0239
Fax
(352) 265-1107
NPI assigned
Mar 29, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 8, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Internal Medicine Physician 207R00000X 85803 SC Primary

Addresses

Primary practice location

1600 SW Archer Rd Ste 4102
Gainesville, FL 32610-3003

Mailing address

4175 NW 50TH Ter Apt 3202
Gainesville, FL 32606-0007

Other practice location 1

800 N Fant St
Anderson, SC 29621
Phone (864) 512-1000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
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 1

Enrollment IDStateProvider typePAC IDDetails
I20210709002313 SC Practitioner - Internal MedicinePractitioner - Hospitalist 9739423393 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Hospitalist
Education
Medical University of South Carolina College of Medicine, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
24 On Physicians PCGroup PAC ID 5698688141, 274 clinicians

Practice addresses (Care Compare)

800 N Fant St
Anderson, SC 29621-5708
Phone (770) 740-0895

955 Ribaut Rd
Beaufort, SC 29902-5441
Phone (843) 522-5005

Hospital & facility affiliations

  • Anmed Home Health Agency Home health agency, Anderson, SC, CCN 427032
  • Anmed Health Hospital, Anderson, SC, CCN 420027

Merit-based Incentive Payment System (MIPS)

Final score
88.96 of 100Reported as group
Quality
77.5
Improvement activities
40
Cost
74.58

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
24 On Physicians, P.C. CurrentSince Jul 1, 2021 Accepting new patients
24 On Physicians, PC CurrentSince Jul 1, 2021 Accepting new patients
Anmed Health Past Accepting new patients

Locations

318 Maxwell Rd
Ste 500
Alpharetta, GA 30009
Phone (770) 274-0473

800 N Fant St
Anderson, SC 29621
Phone (864) 512-1000

955 Ribaut Rd
Beaufort, SC 29902
Phone (803) 522-5200

Interoperability endpoints

  • Direct secure messaging: jlewis333150@direct.shands.ufl.edu

Organizations & group practices 3

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1522281600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623110400000",
    "number": "1053816173",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4175 NW 50TH TER APT 3202",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326060007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 SW ARCHER RD STE 4102",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326103003",
            "telephone_number": "352-265-0239",
            "fax_number": "352-265-1107"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "800 N Fant St",
            "address_purpose": "LOCATION",
            "city": "Anderson",
            "state": "SC",
            "postal_code": "29621",
            "country_code": "US",
            "telephone_number": "864-512-1000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEWIS",
        "first_name": "JUSTIN",
        "middle_name": "EDWARD",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-03-29",
        "last_updated": "2021-06-08",
        "certification_date": "2021-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "SC",
            "license": "85803",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gainesville, FL

Sources for this page

Verify at the official NPI Registry.