Individual provider Active NPI

Odelia N. Lewis, MD

  • Family Medicine Physician
  • Brooklyn, NY
National Provider Identifier
1205330693
Registry record updated Oct 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
312488 Issued in NY
Practice address
650 Fulton St
Brooklyn, NY 11217-1517
Phone
(718) 596-9800
Fax
(877) 460-4752
NPI assigned
Mar 20, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 24, 2025

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 312488 NY Primary

Addresses

Primary practice location

650 Fulton St
Brooklyn, NY 11217-1517

Mailing address

650 Fulton St
Brooklyn, NY 11217-1517
Phone (718) 596-9800

Other practice location 1

297 Myrtle Ave
Brooklyn, NY 11205-2901
Phone (718) 596-8000 ext. 36662

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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

Enrollment IDStateProvider typePAC IDDetails
I20210910001663 NY Practitioner - Family Practice 0042616369 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
312488NYMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Brownsville Community Development Corporation Current Accepting new patients
Maimonides Medical Center Current Accepting new patients
Brooklyn Plaza Medical Center, Inc CurrentSince May 22, 2024 Accepting new patients
Brownsville Community Development Corporation CurrentSince May 19, 2021 Accepting new patients
Whitman Ingersoll Farragut Health Center CurrentSince May 22, 2024 Accepting new patients
Brownsville Community Development Corporation CurrentSince May 19, 2021 Accepting new patients

Locations

592 Rockaway Ave
Brooklyn, NY 11212
Phone (718) 345-5000

297 Myrtle Ave
Brooklyn, NY 11205
Phone (718) 596-8000

450 Clarkson Ave
Brooklyn, NY 11203
Phone (718) 270-1603

650 Ashford St
Brooklyn, NY 11207
Phone (347) 505-1800

650 Fulton St
Brooklyn, NY 11217
Phone (718) 596-9800

650 Fulton St
#0
Brooklyn, NY 11217

Networks

  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H5989

Interoperability endpoints

  • Direct secure messaging: odelialewis@mai.allscriptsdirect.net

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.

NPI Registry JSON

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

{
    "created_epoch": "1521504000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761264000000",
    "number": "1205330693",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "650 FULTON ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112171517",
            "telephone_number": "718-596-9800",
            "fax_number": "877-460-4752"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "650 FULTON ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112171517",
            "telephone_number": "718-596-9800",
            "fax_number": "877-460-4752"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "297 Myrtle Ave",
            "address_purpose": "LOCATION",
            "city": "Brooklyn",
            "state": "NY",
            "postal_code": "112052901",
            "country_code": "US",
            "telephone_number": "718-596-8000 x36662",
            "fax_number": "877-460-4752",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEWIS",
        "first_name": "ODELIA",
        "middle_name": "N.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-03-20",
        "last_updated": "2025-10-24",
        "certification_date": "2025-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "312488",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.