Individual provider Active NPI

Chelby Lewis, PA-C

  • Physician Assistant
  • Troy, MI
National Provider Identifier
1205558459
Registry record updated Dec 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
5601011403 Issued in MI
Practice address
44201 Dequindre Rd
Troy, MI 48085-1117
Phone
(248) 964-8193
NPI assigned
Sep 14, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 19, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X
Physician Assistant 363A00000X 5601011403 MI Primary

Addresses

Primary practice location

44201 Dequindre Rd
Troy, MI 48085-1117

Mailing address

26901 Beaumont Blvd Ste 3D
Southfield, MI 48033-3849
Phone (947) 522-1860

Other practice location 1

807 E Lincoln Ave
Royal Oak, MI 48067-3357
Phone (307) 254-4087

Other practice location 2

44250 Dequindre Rd
Sterling Heights, MI 48314-1002
Phone (248) 964-9715

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address clewis5347113@direct.beaumont.edu

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20221221001369 MI Practitioner - Physician Assistant 6204206931 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

28100 Grand River Ave
Farmington Hills, MI 48336-5970

44201 Dequindre Rd
Troy, MI 48085-1117
Phone (248) 964-0535

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
84.37 of 100Reported as group
Quality
66.73
Promoting interoperability
100
Improvement activities
40
Cost
70.98

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Interoperability endpoints

  • Direct secure messaging: clewis1243661@epic00.shdirect.org
  • Direct secure messaging: clewis5347113@direct.beaumont.edu

Organizations & group practices 1

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.

Hospital & facility affiliations 1

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": "1663113600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1671408000000",
    "number": "1205558459",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26901 BEAUMONT BLVD STE 3D",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480333849",
            "telephone_number": "947-522-1860"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "44201 DEQUINDRE RD",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480851117",
            "telephone_number": "248-964-8193"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "807 E Lincoln Ave",
            "address_purpose": "LOCATION",
            "city": "Royal Oak",
            "state": "MI",
            "postal_code": "480673357",
            "country_code": "US",
            "telephone_number": "307-254-4087",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "44250 Dequindre Rd",
            "address_purpose": "LOCATION",
            "city": "Sterling Heights",
            "state": "MI",
            "postal_code": "483141002",
            "country_code": "US",
            "telephone_number": "248-964-9715",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEWIS",
        "first_name": "CHELBY",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-09-14",
        "last_updated": "2022-12-19",
        "certification_date": "2022-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601011403",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "clewis5347113@direct.beaumont.edu",
            "affiliation": "N",
            "address_1": "44201 Dequindre Rd",
            "city": "Troy",
            "state": "MI",
            "country_code": "US",
            "postal_code": "480851117",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Troy, MI

Sources for this page

Verify at the official NPI Registry.