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Individual provider Active NPI

Adolphus Ray Lewis, DO

  • Family Medicine Physician
  • Fort Worth, TX
National Provider Identifier
1265403497
Registry record updated Sep 23, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
H2532 Issued in TX
Practice address
4732 E Lancaster Ave Ste a
Fort Worth, TX 76103-3836
Phone
(817) 534-1010
Fax
(817) 413-0300
NPI assigned
Jan 27, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2016

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 H2532 TX Primary

Addresses

Primary practice location

4732 E Lancaster Ave Ste a
Fort Worth, TX 76103-3836

Mailing address

4732 E Lancaster Ave Ste a
Fort Worth, TX 76103-3836
Phone (817) 534-1010

Other identifiers 3

IdentifierTypeStateIssuer
8CG231OtherTXBLUE CROSS BLUE SHIELD
P00864759OtherTXPALMETTO GBA RAILROAD MEDICARE
1215196-07MedicaidTX

Other names 1

  • A. Ray Lewis Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041116000102 TX Practitioner - Family PracticePractitioner - Geriatric Medicine 4880505403 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Geriatric Medicine
Education
University of North Texas HSC, College of Osteopathic Med, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

4732 E Lancaster Ave
Suite B
Fort Worth, TX 76103-3836
Phone (817) 413-0943

Hospital & facility affiliations

  • Valor Hospice Hospice, Fort Worth, TX, CCN 741787
  • Hospice Healthcare Network Hospice, Arlington, TX, CCN 451720
  • Village Creek Nursing & Rehabilitation Nursing home, Fort Worth, TX, CCN 675977
  • Arbor Lake Nursing & Rehabilitation, LLC Nursing home, Fort Worth, TX, CCN 675034
  • Immanuel'S Healthcare Nursing home, Fort Worth, TX, CCN 676052
  • Park View Care Center Nursing home, Fort Worth, TX, CCN 455606
  • Benbrook Nursing & Rehabilitation Center Nursing home, Benbrook, TX, CCN 675906

Merit-based Incentive Payment System (MIPS)

Final score
24.5 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
81.67

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue12

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Osteopathy, Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
H2582TXMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
A Ray Lewis, DO, PLLC Family Medicine CurrentSince Jun 9, 2010 Accepting new patients
Health Star Systems, LLC CurrentSince Sep 22, 2022 Accepting new patients
Frio Hospital District Past Accepting new patients
Frio Hospital District Past Accepting new patients
Fort Worth Skilled Care, LLC Past Accepting new patients
Palo Pinto County Hospital District Family Medicine PastSince Aug 1, 2021 Accepting new patients
Diagnostic Swallowing Services Past Accepting new patients
Vpa of Texas PLLC Past Accepting new patients
Chambers County Public Hospital District No. 1 Past Accepting new patients
Jack County Hospital District Past Accepting new patients
Bellville Hospital District Past Accepting new patients
Palo Pinto County Hospital District Past Accepting new patients

Locations

2921 Brown Trl
Ste 135
Bedford, TX 76021
Phone (817) 398-4025

4732 E Lancaster Ave
Ste B
Fort Worth, TX 76103
Phone (817) 413-0943

4732 E Lancaster Ave
Ste A
Fort Worth, TX 76103
Phone (817) 413-0943

3301 View St
Ft Worth, TX 76103
Phone (817) 531-3616

3825 Village Creek Rd
Ft Worth, TX 76119
Phone (817) 429-1991

901 Pennsylvania Ave
Ft Worth, TX 76104
Phone (817) 335-3030

4732 E Lancaster Ave
Ft Worth, TX 76103
Phone (817) 413-0943

4515 Village Creek Rd
Ft Worth, TX 76119
Phone (817) 451-8704

4900 E Berry St
Ft Worth, TX 76105
Phone (817) 531-1370

658 SW 3rd St
Grand Prairie, TX 75051
Phone (325) 669-8695

2712 Hurstview Dr
Hurst, TX 76054
Phone (817) 281-6407

Ownership & related parties

All facility ownership & control disclosures 4

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Benbrook Nursing and Rehabilitation CenterBenbrook, TX, CCN 675906 Skilled nursing facility Adp of the SNF Aug 1, 2021
Arbor Lake Nursing & RehabilitationFort Worth, TX, CCN 675034 Skilled nursing facility Adp of the SNF Jan 1, 1994
Village Creek Nursing & RehabilitationFort Worth, TX, CCN 675977 Skilled nursing facility Adp of the SNF Jan 1, 1989
Hospice Healthcare NetworkArlington, TX, CCN 451720 Hospice Contracted Managing Employee Dec 1, 2002

Owned or controlled facilities with NPI records 4

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 12

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 7

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": "1138320000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1474588800000",
    "number": "1265403497",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4732 E LANCASTER AVE STE A",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761033836",
            "telephone_number": "817-534-1010",
            "fax_number": "817-413-0300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4732 E LANCASTER AVE STE A",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761033836",
            "telephone_number": "817-534-1010",
            "fax_number": "817-413-0300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEWIS",
        "first_name": "ADOLPHUS",
        "middle_name": "RAY",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-27",
        "last_updated": "2016-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "H2532",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "8CG231",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PALMETTO GBA RAILROAD MEDICARE",
            "identifier": "P00864759",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1215196-07",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "A.",
            "last_name": "LEWIS",
            "middle_name": "RAY",
            "credential": "DO",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Fort Worth, TX

Sources for this page

Verify at the official NPI Registry.