Active NPI
Rachel Ellen Lewis, M.D.
- Dermatology Physician
- Watertown, NY
National Provider Identifier
1336168053
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dermatology Physician
- License
- 191378-1
- Practice address
- 1575 Washington St
Watertown, NY 13601-9371 - Phone
- (315) 786-7300
- NPI assigned
- Jul 19, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dermatology Physician | 207N00000X | 191378-1 | NY | Primary |
Addresses
Primary practice location
1575 Washington St
Watertown, NY 13601-9371
Mailing address
1575 Washington St
Watertown, NY 13601-9371
Phone (315) 786-7300
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 01445234 | Medicaid | NY |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 191378-1 | NY | MD | Dermatology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153267200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1334188800000",
"number": "1336168053",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1575 WASHINGTON ST",
"city": "WATERTOWN",
"state": "NY",
"postal_code": "136019371",
"telephone_number": "315-786-7300"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1575 WASHINGTON ST",
"city": "WATERTOWN",
"state": "NY",
"postal_code": "136019371",
"telephone_number": "315-786-7300"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEWIS",
"first_name": "RACHEL",
"middle_name": "ELLEN",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-07-19",
"last_updated": "2012-04-12",
"status": "A"
},
"taxonomies": [
{
"code": "207N00000X",
"taxonomy_group": "",
"desc": "Dermatology",
"state": "NY",
"license": "191378-1",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "01445234",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Watertown, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.