Annette Lewellyn, CBMF

Primary specialty

Mastectomy FitterTaxonomy code 224900000X

License

C51810 Issued in CA

Practice address

2500 Mowry Ave # 130
Fremont, CA 94538-1605

Phone

(510) 790-1911

Fax

(510) 505-9160

NPI assigned

Feb 8, 2022

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Hers Breast Cancer Foundation

  • Durable Medical Equipment & Medical Supplies
  • Livermore, CA
  • NPI 1104649532
  NPD

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

{
    "created_epoch": "1644278400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644278400000",
    "number": "1396499430",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2500 MOWRY AVE # 130",
            "city": "FREMONT",
            "state": "CA",
            "postal_code": "945381605",
            "telephone_number": "510-790-1911",
            "fax_number": "510-505-9160"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 MOWRY AVE # 130",
            "city": "FREMONT",
            "state": "CA",
            "postal_code": "945381605",
            "telephone_number": "510-790-1911",
            "fax_number": "510-505-9160"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEWELLYN",
        "first_name": "ANNETTE",
        "credential": "CBMF",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-02-08",
        "last_updated": "2022-02-08",
        "certification_date": "2022-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224900000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Mastectomy Fitter",
            "state": "CA",
            "license": "C51810",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ka Yan Leung
• Kevin Leung, PHARM.D.
• David Levin, MD
• Eliana Renee Levin
• Donald Lew
• Tegwyn Lewis-Pine, NP
• David McNamara Lewis, M.D.
• Elizabeth Lewis, CNM
• Lance B Lewis
• Susan E Lewis, OTR

• Mastectomy Fitter in Fremont, CA
• Providers in Fremont, CA by specialty
• Mastectomy Fitter in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.