Active NPI
Lewis Richard Gergoudis, MD
- Family Medicine Physician
- Jamaica Plain, MA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 1025841
- Practice address
- 1153 Centre St
Jamaica Plain, MA 02130-3446 - Phone
- (617) 983-7300
- NPI assigned
- Apr 24, 2018
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 1025841 | MA | Primary |
Addresses
Primary practice location
1153 Centre St
Jamaica Plain, MA 02130-3446
Mailing address
399 Revolution Dr
Somerville, MA 02145-1484
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NC
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Family Practice
- Education
- Virginia Commonwealth University, School of Medicine, 2018
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Proactive Therapy of North Carolina IncBrigham and Womens Physicians Organization Inc
Practice addresses (Care Compare)
101 Heart Dr
Greenville, NC 27834-8982
Phone (252) 744-3109
2303 Wellington Dr SW
Wilson, NC 27893-8620
Phone (252) 243-6818
75 Francis St
Boston, MA 02115-6110
Phone (617) 732-5500
Hospital & facility affiliations
Merit-based Incentive Payment System (MIPS)
- Final score
- 96.95 of 100
- Quality
- 82.44
- Promoting interoperability
- 100
- Improvement activities
- 40
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Removal of tissue | 20 |
| Removal of nail tissue | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2021-01397 | NC | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| East Carolina University | Family Medicine | Current | Accepting new patients |
| East Carolina University | Current | Accepting new patients |
Locations
2100 Stantonsburg Rd
Greenville, NC 27834
Phone (252) 744-3229
101 Heart Dr
Greenville, NC 27834
Phone (252) 744-4611
600 Moye Blvd
Greenville, NC 27834
Phone (252) 744-1111
Interoperability endpoints
- lgergoudis276178@direct.ecuhealth.com
Organizations & group practices 2
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.
-
- Internal Medicine Physician
- Greenville, NC
- NPI 1043260474
Hospital & facility affiliations 5
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Boston, MA
- NPI 1578677811
-
- Psychiatric Hospital Unit
- Boston, MA
- NPI 1033121025
-
dba CenterWell Home Health
- Home Health Agency
- Greenville, NC
- NPI 1396775136
-
dba ECU Health Beaufort Hospital-a campus of ECU Health Medical Center
- General Acute Care Hospital
- Washington, NC
- NPI 1780359687
-
dba ECU Health Medical Center
- General Acute Care Hospital
- Greenville, NC
- NPI 1043218944
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1524528000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1782259200000",
"number": "1356839518",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "399 REVOLUTION DR",
"city": "SOMERVILLE",
"state": "MA",
"postal_code": "021451484"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1153 CENTRE ST",
"city": "JAMAICA PLAIN",
"state": "MA",
"postal_code": "021303446",
"telephone_number": "617-983-7300"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GERGOUDIS",
"first_name": "LEWIS",
"middle_name": "RICHARD",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-04-24",
"last_updated": "2026-06-24",
"certification_date": "2026-06-24",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "MA",
"license": "1025841",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Jamaica Plain, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.