Individual provider Active NPI

Lewis Michael Brown, PH.D.

  • Psychologist
  • Brooklyn, NY
National Provider Identifier
1114918885
Registry record updated Jun 4, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
09119-1 Issued in NY
Practice address
68 Saint Marks PL
Brooklyn, NY 11217-1945
Phone
(718) 834-1646
Fax
(718) 834-1323
NPI assigned
Nov 2, 2005
Last updated
Jun 4, 2008By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 4, 2008

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 09119-1 NY Primary
Psychologist 103T00000X 1076 NC

Addresses

Primary practice location

68 Saint Marks PL
Brooklyn, NY 11217-1945

Mailing address

PO Box 170297
Brooklyn, NY 11217-0297
Phone (718) 834-1646

Other identifiers 1

IdentifierTypeStateIssuer
01444128MedicaidNY

Other names 1

  • Dr. Lew Brown Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, NC2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20050819000297 NY Practitioner - Clinical Psychologist 7012947930
I20110817000559 NC Practitioner - Clinical Psychologist 7012947930 Practice locations: Charlotte, NC

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
09119-1NYMDPsychologist

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1130889600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1212537600000",
    "number": "1114918885",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 170297",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112170297",
            "telephone_number": "718-834-1646",
            "fax_number": "718-834-1323"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "68 SAINT MARKS PL",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112171945",
            "telephone_number": "718-834-1646",
            "fax_number": "718-834-1323"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN",
        "first_name": "LEWIS",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-11-02",
        "last_updated": "2008-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NY",
            "license": "09119-1",
            "primary": true
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NC",
            "license": "1076",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01444128",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LEW",
            "last_name": "BROWN",
            "prefix": "DR.",
            "credential": "PH.D.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.