Jason Dean Lew, MD
Individual provider Active NPI Obstetrics & Gynecology Physician · Vineyard Haven, MA
NPI 1205908142 · NPPES record last updated Jan 24, 2009
Key facts
- NPI
- 1205908142
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Obstetrics & Gynecology Physician 207V00000X
- License
- 49236 (MA)
- Practice address
- 395 State Road
Vineyard Haven, MA 02568 - Phone
- (508) 693-6747
- Fax
- (508) 693-6744
- NPI assigned
- Nov 15, 2006
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 49236 | MA | MD | Obstetrics & Gynecology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Jordan Physician Associates, Inc. | Obstetrics & Gynecology | Past | Accepting new patients |
| Jordan Physician Associates, Inc. | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Obstetrics & Gynecology Physician | 207V00000X | 49236 | MA | Yes |
Addresses
Primary practice location
395 State Road
Vineyard Haven, MA 02568
Mailing address
PO Box 1235
Oak Bluffs, MA 02557
Phone (508) 693-6744
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| L20020 | Other | BCBS | |
| 13157 | Other | MA | HARVARD PILGRIM |
| 0162574 | Medicaid | MA | |
| 718415 | Other | TUFTS |
Other providers in Vineyard Haven, MA
- Evan Macdonald Lamont
- Alyson Lanzone
- Chelsea Leblanc
- Abigail Leighton
- Brenda Lee Leonard
- Amy Lilavois
- Kathleen M Lingren
- Jesse Liotta
- Jamie G Loschen
- Veronica Lundgren
All providers in Vineyard Haven, MA · Obstetrics & Gynecology Physician in Massachusetts
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 24, 2009. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.