Individual provider Active NPI

Jewel A Lewis, OD

  • Optometrist
  • Gibson City, IL
National Provider Identifier
1386696078
Registry record updated Feb 7, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
04600008576 Issued in IL
Practice address
220 E 1St St
Gibson City, IL 60936-1704
Phone
(217) 784-4912
Fax
(217) 784-4912
NPI assigned
May 17, 2006
Last updated
Feb 7, 2015By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 7, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 04600008576 IL Primary

Addresses

Primary practice location

220 E 1St St
Gibson City, IL 60936-1704

Mailing address

220 E 1St St
Gibson City, IL 60936-1704
Phone (217) 784-4912

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060117000782 IL Practitioner - Optometry 9931123007 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Illinois College of Optometry at Chicago, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

220 E 1St St
Gibson City, IL 60936-1704

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery53

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
04600008576ILMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Flavel J. Heyman Optometrist Current Accepting new patients
Gibson Community Hospital Association Past Accepting new patients
Carle Health Medical Group Past Accepting new patients
Gailey Eye Clinic, LTD Past Accepting new patients
Chittick Family Eye Care LTD Optometrist PastSince Dec 26, 2022 Accepting new patients

Locations

145 W Center St
Paxton, IL 60957
Phone (217) 379-3121

145 W Center St
#J
Paxton, IL 60957
Phone (217) 379-3121

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1147824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1423267200000",
    "number": "1386696078",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "220 E 1ST ST",
            "city": "GIBSON CITY",
            "state": "IL",
            "postal_code": "609361704",
            "telephone_number": "217-784-4912",
            "fax_number": "217-784-4912"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "220 E 1ST ST",
            "city": "GIBSON CITY",
            "state": "IL",
            "postal_code": "609361704",
            "telephone_number": "217-784-4912",
            "fax_number": "217-784-4912"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEWIS",
        "first_name": "JEWEL",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-05-17",
        "last_updated": "2015-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": "04600008576",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gibson City, IL

Sources for this page

Verify at the official NPI Registry.