NPIMap

Individual provider Active NPI

Joel M. Lewis, DO

  • Family Medicine Physician
  • Santa Rosa, CA
National Provider Identifier
1144304114
Registry record updated Jul 24, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
20A6145 Issued in CA
Practice address
983 Sonoma Ave
Santa Rosa, CA 95404-4818
Phone
(707) 583-8700
NPI assigned
Oct 25, 2006
Last updated
Jul 24, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 24, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 20A6145 CA Primary

Addresses

Primary practice location

983 Sonoma Ave
Santa Rosa, CA 95404-4818

Mailing address

983 Sonoma Ave
Santa Rosa, CA 95404-4818
Phone (707) 303-3600

Other identifiers 1

IdentifierTypeStateIssuer
020A61450MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20050622000902 CA Practitioner - Family PracticePractitioner - Osteopathic Manipulative Medicine 2769427574 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

3569 Round Barn Cir
Santa Rosa, CA 95403-5781
Phone (707) 303-3600

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Santa Rosa Community Health Centers CurrentSince Jan 17, 2025 Accepting new patients
Santa Rosa Community Health Centers CurrentSince Jan 17, 2025 Accepting new patients

Locations

3569 Round Barn Cir
Santa Rosa, CA 95403

Interoperability endpoints

  • Direct secure messaging: jlewis627516@direct.ochin.org

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 6

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": "1161734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1532390400000",
    "number": "1144304114",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "983 SONOMA AVE",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954044818",
            "telephone_number": "707-303-3600",
            "fax_number": "707-303-3636"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "983 SONOMA AVE",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954044818",
            "telephone_number": "707-583-8700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEWIS",
        "first_name": "JOEL",
        "middle_name": "M.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-25",
        "last_updated": "2018-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "20A6145",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "020A61450",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Rosa, CA

Sources for this page

Verify at the official NPI Registry.