Individual provider Active NPI

Tryphena T Lewis, NP

  • Neonatal Nurse Practitioner
  • Baltimore, MD
National Provider Identifier
1164754586
Registry record updated May 26, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neonatal Nurse PractitionerTaxonomy code 363LN0000X
License
R136634 Issued in MD
Practice address
301 St. Paul Place
Department of Pediatrics
Baltimore, MD 21202-2102
Phone
(410) 332-9594
NPI assigned
Feb 10, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 26, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Neonatal Nurse Practitioner 363LN0000X R136634 MD Primary
Family Nurse Practitioner 363LF0000X R136634 MD

Addresses

Primary practice location

301 St. Paul Place
Department of Pediatrics
Baltimore, MD 21202-2102

Mailing address

301 St. Paul Place
Medical Staff Services
Baltimore, MD 21202-2102
Phone (410) 332-9407

Other practice location 1

1730 Merritt Blvd
Dundalk, MD 21222-3212
Phone (410) 650-4730

Electronic endpoints 2

TypeEndpointUseAffiliation
Other URL mercy Direct
Other URL mercy Direct

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100330000277 MD Practitioner - Nurse Practitioner 5991831919 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Umms Ambulatory Care LLC CurrentSince May 2, 2022 Accepting new patients
Umms Ambulatory Care LLC CurrentSince May 2, 2022 Accepting new patients
Umms Ambulatory Care LLC Current Accepting new patients

Locations

8 Denton Plz
Denton, MD 21629
Phone (443) 606-2300

1730 Merritt Blvd
Dundalk, MD 21222
Phone (410) 282-2756

28522 Marlboro Ave
#C
Easton, MD 21601
Phone (443) 746-0086

900 Elkridge Landing Rd
Fl 2
Linthicum Heights, MD 21090
Phone (443) 462-5010

Interoperability endpoints

  • Direct secure messaging: tlewis35527@direct.mdmercy.com

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1265760000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1653523200000",
    "number": "1164754586",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 ST. PAUL PLACE",
            "address_2": "MEDICAL STAFF SERVICES",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212022102",
            "telephone_number": "410-332-9407"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 ST. PAUL PLACE",
            "address_2": "DEPARTMENT OF PEDIATRICS",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212022102",
            "telephone_number": "410-332-9594"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1730 Merritt Blvd",
            "address_purpose": "LOCATION",
            "city": "Dundalk",
            "state": "MD",
            "postal_code": "212223212",
            "country_code": "US",
            "telephone_number": "410-650-4730",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEWIS",
        "first_name": "TRYPHENA",
        "middle_name": "T",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-02-10",
        "last_updated": "2022-05-26",
        "certification_date": "2022-05-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LN0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Neonatal",
            "state": "MD",
            "license": "R136634",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MD",
            "license": "R136634",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "mercy",
            "affiliation": "N",
            "endpointDescription": "hospital",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "TLEWIS@MDMERCY.COM",
            "address_1": "301 St. Paul Place",
            "address_2": "Department of Pediatrics",
            "city": "Baltimore",
            "state": "MD",
            "country_code": "US",
            "postal_code": "212022102",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "mercy",
            "affiliation": "N",
            "endpointDescription": "hospital",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "TLEWIS@MDMERCY.COM",
            "address_1": "301 St. Paul Place",
            "address_2": "Department of Pediatrics",
            "city": "Baltimore",
            "state": "MD",
            "country_code": "US",
            "postal_code": "212022102",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.