Diane M Derr Lewis, PHD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

5384 Issued in OH

Practice address

3425 Executive Pkwy
Suite 230
Toledo, OH 43606-1326

Phone

(419) 531-3500

Fax

(419) 531-1877

NPI assigned

Jan 4, 2007

Sex

Female

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 4

Medicare fee-for-service enrollment

Enrolled in OH

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 1

Specialty

Clinical Psychologist

Education

Other, 1987

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Central Behavioral Healthcare IncGroup PAC ID 9931178092, 5 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

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.

• Central Behavioral Healthcare Inc

  • Clinical Psychologist
  • Toledo, OH
  • NPI 1902829880

  Clinical, OH

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1167868800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1335830400000",
    "number": "1194872952",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 74872",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441940002",
            "telephone_number": "419-531-3500",
            "fax_number": "419-531-1877"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3425 EXECUTIVE PKWY",
            "address_2": "SUITE 230",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436061326",
            "telephone_number": "419-531-3500",
            "fax_number": "419-531-1877"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DERR LEWIS",
        "first_name": "DIANE",
        "middle_name": "M",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-04",
        "last_updated": "2012-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "OH",
            "license": "5384",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0911811",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PARAMOUNT INDIVIDUAL PR",
            "identifier": "03023",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM INDIVIDUAL PROV #",
            "identifier": "000000388012",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA PROV #",
            "identifier": "267100000",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Harry John Dermanelian II, DC
• Lindsay Marie Dernier, STNA
• James Derosa, LISW
• Kayla Derouen
• Laura Anne Derousse, CT
• Anuj M Desai, DO
• Chintan Jatinbhai Desai, M.B.B.S.
• Shaili Desai, MD
• Paul R Desaint Victor, MD
• Brandon Miguel Desantos

• All providers in Toledo, OH
• Clinical Psychologist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.