Individual provider Active NPI

Stacy Lewin, MD

  • Anesthesiology Physician
  • Marlton, NJ
National Provider Identifier
1396745030
Registry record updated Sep 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
25MA07261800 Issued in NJ
Practice address
102 Centre Blvd
Marlton, NJ 08053-4129
Phone
(856) 988-6260
Fax
(856) 988-6270
NPI assigned
Jul 22, 2005
Last updated
Sep 13, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 13, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 25MA07261800 NJ Primary

Addresses

Primary practice location

102 Centre Blvd
Marlton, NJ 08053-4129

Mailing address

102 Centre Blvd Ste E
Marlton, NJ 08053-4129
Phone (856) 988-6260

Other practice location 1

100 Bowman Dr Fl 2
Voorhees, NJ 08043-9612
Phone (856) 988-6260

Other identifiers 1

IdentifierTypeStateIssuer
050099MedicaidNJ

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address slewin18764@directvirtua.org
Direct Messaging Address slewin18764@directvirtua.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MA07261800NJMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Capstone Behavioral Health L.L.C. PastSince Aug 25, 2019 Accepting new patients

Organizations & group practices 1

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": "1121990400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726185600000",
    "number": "1396745030",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 CENTRE BLVD STE E",
            "city": "MARLTON",
            "state": "NJ",
            "postal_code": "080534129",
            "telephone_number": "856-988-6260",
            "fax_number": "856-988-6270"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 CENTRE BLVD",
            "city": "MARLTON",
            "state": "NJ",
            "postal_code": "080534129",
            "telephone_number": "856-988-6260",
            "fax_number": "856-988-6270"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "100 Bowman Dr Fl 2",
            "address_purpose": "LOCATION",
            "city": "Voorhees",
            "state": "NJ",
            "postal_code": "080439612",
            "country_code": "US",
            "telephone_number": "856-988-6260",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEWIN",
        "first_name": "STACY",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-07-22",
        "last_updated": "2024-09-13",
        "certification_date": "2024-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NJ",
            "license": "25MA07261800",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "050099",
            "state": "NJ"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "slewin18764@directvirtua.org",
            "affiliation": "N",
            "address_1": "100 Bowman Dr Fl 2",
            "city": "Voorhees",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "080439612",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "slewin18764@directvirtua.org",
            "affiliation": "N",
            "address_1": "200 Bowman Dr Ste D160",
            "city": "Voorhees",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "080439633",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Marlton, NJ

Sources for this page

Verify at the official NPI Registry.