NPIMap

Individual provider Active NPI

Bertram A Lewis Jr., M.D., PH.D. MBA FACS

  • Urology Physician
  • Zephyrhills, FL
National Provider Identifier
1124096060
Registry record updated Mar 17, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
ME103274 Issued in FL
Practice address
6748 Gall Blvd
Zephyrhills, FL 33542-2544
Phone
(813) 779-1209
Fax
(813) 779-1216
NPI assigned
Mar 8, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2016

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X 9901570 NC
Urology Physician 208800000X 35491 AZ
Urology Physician 208800000X ME103274 FL Primary

Addresses

Primary practice location

6748 Gall Blvd
Zephyrhills, FL 33542-2544

Mailing address

6748 Gall Blvd
Zephyrhills, FL 33542-2544
Phone (813) 779-1209

Other identifiers 14

IdentifierTypeStateIssuer
001360600MedicaidFL
7661457OtherAZAETNA
135924OtherAZHEALTH CHOICE ARIZONA
135924MedicaidAZ
6005682OtherFLCIGNA
6005682OtherAZCIGNA
7661457OtherFLAETNA
330605OtherFLAVMED
AZ0921980OtherAZBCBS
P00793962OtherFLMEDICARE RAILROAD
135924002OtherAZARIZONA PHYSICIANS IPA
1463HOtherFLBCBS
2Z8105OtherAZHEALTH NET OF ARIZONA
529993OtherFLWELLCARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20091017000007 FL Practitioner - Urology 3274502513 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
Johns Hopkins University School of Medicine, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Florida Hospital Physician Group IncGroup PAC ID 2365679057, 953 clinicians
Florida Hospital Zephyrhills IncGroup PAC ID 2466499678, 14 clinicians

Practice addresses (Care Compare)

2590 Healing Way
Suite 210
Wesley Chapel, FL 33543-5497
Phone (813) 782-5801

2600 Bruce B Downs Blvd
Wesley Chapel, FL 33544-9207
Phone (813) 929-5436

2700 Healing Way
Wesley Chapel, FL 33543-5453

7050 Gall Blvd
Zephyrhills, FL 33541-1347
Phone (813) 788-0411

Hospital & facility affiliations

  • Adventhealth Zephyrhills Hospital, Zephyrhills, FL, CCN 100046
  • Adventhealth Wesley Chapel Hospital, Wesley Chapel, FL, CCN 100319
  • Adventhealth Tampa Hospital, Tampa, FL, CCN 100173
  • Adventhealth Dade City Hospital, Dade City, FL, CCN 100211

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

Procedures performed for Medicare patients

ProcedureNumber of procedures
Prostate resection14

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35491AZMDUrology Physician
ME103274FLMDUrology Physician
9901570NCMDUrology Physician

Practice roles (6 of 8)

OrganizationSpecialtyStatusNew patients
Florida Hospital Zephyrhills Inc CurrentSince Sep 1, 2009 Accepting new patients
Florida Hospital Zephyrhills Inc CurrentSince Sep 1, 2009 Accepting new patients
Florida Hospital Physician Group Inc CurrentSince Sep 22, 2024 Accepting new patients
Bullhead City Clinic Corp Urology PastSince Apr 1, 2009 Accepting new patients
Bullhead City Clinic Corp Past Accepting new patients
Carolina Specialty Oncology, PA Urology Past Accepting new patients

Locations

7040 Land O Lakes Blvd
Unit 103
Land O Lakes, FL 34638
Phone (813) 779-1209

2435 Bexley Village Dr
Ste 200
Land O Lakes, FL 34638
Phone (813) 467-4771

30115 Highway 52
Ste 101
San Antonio, FL 33576
Phone (813) 467-4244

13901 Bruce B Downs Blvd
Tampa, FL 33613
Phone (813) 615-7260

2700 Healing Way
Ste 310
Wesley Chapel, FL 33543
Phone (813) 779-1209

2590 Healing Way
Ste 210
Wesley Chapel, FL 33543
Phone (813) 467-4285

6748 Gall Blvd
Zephyrhills, FL 33542
Phone (813) 467-4270

7050 Gall Blvd
Zephyrhills, FL 33541
Phone (813) 779-1209

38240 Daughtery Rd
Zephyrhills, FL 33540
Phone (813) 788-3582

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: blewis626289@adventhealth.direct-ci.com

Organizations & group practices 6

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 5

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": "1141776000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1458172800000",
    "number": "1124096060",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6748 GALL BLVD",
            "city": "ZEPHYRHILLS",
            "state": "FL",
            "postal_code": "335422544",
            "telephone_number": "813-779-1209",
            "fax_number": "813-779-1216"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6748 GALL BLVD",
            "city": "ZEPHYRHILLS",
            "state": "FL",
            "postal_code": "335422544",
            "telephone_number": "813-779-1209",
            "fax_number": "813-779-1216"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEWIS",
        "first_name": "BERTRAM",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "M.D., PH.D. MBA FACS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-08",
        "last_updated": "2016-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "NC",
            "license": "9901570",
            "primary": false
        },
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "AZ",
            "license": "35491",
            "primary": false
        },
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "FL",
            "license": "ME103274",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001360600",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7661457",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH CHOICE ARIZONA",
            "identifier": "135924",
            "state": "AZ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "135924",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "6005682",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "6005682",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7661457",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AVMED",
            "identifier": "330605",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "AZ0921980",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "P00793962",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ARIZONA PHYSICIANS IPA",
            "identifier": "135924002",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "1463H",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH NET OF ARIZONA",
            "identifier": "2Z8105",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLCARE",
            "identifier": "529993",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Zephyrhills, FL

Sources for this page

Verify at the official NPI Registry.