Individual provider Active NPI

Jack Byron Lewis, M.D.

  • Urology Physician
  • Mansfield, TX
National Provider Identifier
1396706487
Registry record updated Sep 21, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
MD28015 Issued in OR
Practice address
252 Matlock Rd Ste 244
Mansfield, TX 76063-4294
Phone
(817) 784-8268
Fax
(817) 477-8881
NPI assigned
Mar 29, 2006
Last updated
Sep 21, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 21, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X 43653-020 WI
Urology Physician 208800000X MD28015 OR Primary

Addresses

Primary practice location

252 Matlock Rd Ste 244
Mansfield, TX 76063-4294

Mailing address

252 Matlock Rd Ste 244
Mansfield, TX 76063-6565
Phone (817) 784-8268

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR, TX2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20080512000591 OR Practitioner - Urology 4688753965 Reassigns benefits to 1 organization
I20200601000609 TX Practitioner - Urology 4688753965 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
43653-020WIMDUrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Medical Clinic of North Texas, PLLC Urology Current Accepting new patients
Medical Clinic of North Texas PLLC CurrentSince Apr 27, 2020 Accepting new patients
Medical Clinic of North Texas, PLLC Urology CurrentSince Apr 27, 2020 Accepting new patients
Curry Health District Past Accepting new patients
Curry Health District Past Accepting new patients

Locations

809 W Randol Mill Rd
Arlington, TX 76012
Phone (817) 277-7133

900 Airport Fwy
Ste 158
Hurst, TX 76054
Phone (817) 514-4000

4001 W 15th St
Ste 245
Plano, TX 75093
Phone (972) 596-5222

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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": "1143590400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1789948800000",
    "number": "1396706487",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "252 MATLOCK RD STE 244",
            "city": "MANSFIELD",
            "state": "TX",
            "postal_code": "760636565",
            "telephone_number": "817-784-8268",
            "fax_number": "817-477-8881"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "252 MATLOCK RD STE 244",
            "city": "MANSFIELD",
            "state": "TX",
            "postal_code": "760634294",
            "telephone_number": "817-784-8268",
            "fax_number": "817-477-8881"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEWIS",
        "first_name": "JACK",
        "middle_name": "BYRON",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-29",
        "last_updated": "2026-09-21",
        "certification_date": "2026-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "WI",
            "license": "43653-020",
            "primary": false
        },
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "OR",
            "license": "MD28015",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mansfield, TX

Sources for this page

Verify at the official NPI Registry.