Individual provider Active NPI

Jeffrey Ira Lewis, PH.D.

  • Clinical Psychologist
  • Flushing, NY
National Provider Identifier
1255453445
Registry record updated Aug 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
008971 Issued in NY
Practice address
16303 Horace Harding Expy Ste LL5
Flushing, NY 11365-1449
Phone
(718) 445-7920
Fax
(718) 445-7794
NPI assigned
Apr 6, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 8, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 008971 NY Primary

Addresses

Primary practice location

16303 Horace Harding Expy Ste LL5
Flushing, NY 11365-1449

Mailing address

16303 Horace Harding Expy
Suite #302
Flushing, NY 11365-1449
Phone (718) 445-7920

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
008971NYMDOptometrist

NPI Registry JSON

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

{
    "created_epoch": "1175817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691452800000",
    "number": "1255453445",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16303 HORACE HARDING EXPY",
            "address_2": "SUITE #302",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113651449",
            "telephone_number": "718-445-7920",
            "fax_number": "718-445-7794"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16303 HORACE HARDING EXPY STE LL5",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113651449",
            "telephone_number": "718-445-7920",
            "fax_number": "718-445-7794"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEWIS",
        "first_name": "JEFFREY",
        "middle_name": "IRA",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-06",
        "last_updated": "2023-08-08",
        "certification_date": "2023-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "008971",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Flushing, NY

Sources for this page

Verify at the official NPI Registry.