Lew Bradley Disney, MD

Primary specialty

Neurological Surgery PhysicianTaxonomy code 207T00000X

License

A49362 Issued in CA

Practice address

255 E Bonita Ave
Building #9
Pomona, CA 91767-1923

Phone

(909) 450-0369

Fax

(909) 450-0366

NPI assigned

Dec 20, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

• Direct secure messaging: casacolina@direct.casacolina.org

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

• Casa Colina Hospital and Centers for Healthcare

  • Rehabilitation Hospital
  • Pomona, CA
  • NPI 1518327733

  Corporate Director

  CMS ownership

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.

• Scott C Lederhaus MD & Lew B Disney MD PRT Lederhaus Scott C Gen PTR

  • Neurological Surgery Physician
  • Pomona, CA
  • NPI 1871646679
  Medicare reassignment
• Casa Colina Hospital and Centers for Healthcare

  • General Acute Care Hospital
  • Pomona, CA
  • NPI 1952777245
  NPD
• Scott C Lederhaus MD & Lew B Disney MD PRT Lederhaus Scott C Gen PTR

  • Specialist
  • Pomona, CA
  • NPI 1194826503
  NPD (past)

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

{
    "created_epoch": "1135036800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1276560000000",
    "number": "1154307296",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "255 E BONITA AVE",
            "address_2": "BUILDING #9",
            "city": "POMONA",
            "state": "CA",
            "postal_code": "917671923",
            "telephone_number": "909-450-0369",
            "fax_number": "909-450-0366"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "255 E BONITA AVE",
            "address_2": "BUILDING #9",
            "city": "POMONA",
            "state": "CA",
            "postal_code": "917671923",
            "telephone_number": "909-450-0369",
            "fax_number": "909-450-0366"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DISNEY",
        "first_name": "LEW",
        "middle_name": "BRADLEY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-20",
        "last_updated": "2010-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "CA",
            "license": "A49362",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0099730",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Olivia Dinh
• Sandra Dionicio
• Charla Dionisio, PTA
• Brianna Monique Diossi
• Direct Therapy, S&P
• Montana Dixon
• Valerie Dixon
• Rania Djemil
• Christina DO
• Huong DO

• Neurological Surgery Physician in Pomona, CA
• Providers in Pomona, CA by specialty
• Neurological Surgery Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.