NPIMap

Individual provider Active NPI

Jeremiah P Lewis, PA-C

  • Medical Physician Assistant
  • Carmel, IN
National Provider Identifier
1073709622
Registry record updated Dec 7, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
10000791A Issued in IN
Practice address
12289 Hancock St
Ste 34
Carmel, IN 46032-5801
Phone
(317) 815-8950
Fax
(317) 815-8951
NPI assigned
Sep 18, 2007
Last updated
Dec 7, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 7, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 10000791A IN Primary

Addresses

Primary practice location

12289 Hancock St
Ste 34
Carmel, IN 46032-5801

Mailing address

250 N Shadeland Ave
Indianapolis, IN 46219-4959

Other practice location 1

1801 N Senate Blvd MPC 2
Suite 3300
Indianapolis, IN 46202
Phone (317) 923-1787

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jlewis4@direct.iuhealth.org

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100508000143 IN Practitioner - Physician Assistant 8527196716 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cardiothoracic Surgeons IncGroup PAC ID 8729033964, 66 clinicians
Iu Health Medical Group LLCGroup PAC ID 9638617913, 4,382 clinicians

Practice addresses (Care Compare)

1701 N Senate Blvd
Indianapolis, IN 46202-1239
Phone (317) 962-2000

1801 N Senate Blvd
Indianapolis, IN 46202-1228
Phone (317) 923-1787

545 Barnhill Dr
Eh215
Indianapolis, IN 46202-5112
Phone (317) 274-7949

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Midwest Pain Institute Center for Minimally Invasive Spine PC Past Accepting new patients
Indiana University Health Care Associates, Inc. Past Accepting new patients
CCSG LLC Past Accepting new patients
University Medical Diagnostic Associates, Inc. Past Accepting new patients

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/15200/brand/1/csg/1/fhir/r4

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

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": "1190073600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607299200000",
    "number": "1073709622",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 N SHADELAND AVE",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462194959"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12289 HANCOCK ST",
            "address_2": "STE 34",
            "city": "CARMEL",
            "state": "IN",
            "postal_code": "460325801",
            "telephone_number": "317-815-8950",
            "fax_number": "317-815-8951"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1801 N Senate Blvd MPC 2",
            "address_2": "Suite 3300",
            "address_purpose": "LOCATION",
            "city": "Indianapolis",
            "state": "IN",
            "postal_code": "46202",
            "country_code": "US",
            "telephone_number": "317-923-1787",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEWIS",
        "first_name": "JEREMIAH",
        "middle_name": "P",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-09-18",
        "last_updated": "2020-12-07",
        "certification_date": "2020-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "IN",
            "license": "10000791A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jlewis4@direct.iuhealth.org",
            "affiliation": "N",
            "address_1": "1801 N Senate Blvd MPC 2",
            "address_2": "Suite 3300",
            "city": "Indianapolis",
            "state": "IN",
            "country_code": "US",
            "postal_code": "46202",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Carmel, IN

Sources for this page

Verify at the official NPI Registry.