Individual provider Active NPI

Michael N Lewis, LCSW

  • Clinical Social Worker
  • Highlands Ranch, CO
National Provider Identifier
1407173404
Registry record updated Nov 14, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
991764 Issued in CO
Practice address
9139 Ridgeline Blvd
Highlands Ranch, CO 80129-2333
Phone
(303) 338-4545
NPI assigned
Apr 29, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 14, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 991764 CO Primary

Addresses

Primary practice location

9139 Ridgeline Blvd
Highlands Ranch, CO 80129-2333

Mailing address

9139 Ridgeline Blvd
Highlands Ranch, CO 80129-2333
Phone (303) 338-4545

Other identifiers 2

IdentifierTypeStateIssuer
021053OtherCOKAISER COMMERCIAL NUMBER
11508078MedicaidCO

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100806000650 CO Practitioner - Clinical Social Worker 3678606951 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
991764COMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Boulder Community Health CurrentSince May 31, 2024 Accepting new patients
Boulder Community Health CurrentSince May 31, 2024 Accepting new patients

Locations

4801 Riverbend Rd
Ste 300
Boulder, CO 80301
Phone (303) 415-8621

4801 Riverbend Rd
Ste 120A
Boulder, CO 80301
Phone (303) 415-4299

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.

NPI Registry JSON

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

{
    "created_epoch": "1272499200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1352851200000",
    "number": "1407173404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9139 RIDGELINE BLVD",
            "city": "HIGHLANDS RANCH",
            "state": "CO",
            "postal_code": "801292333",
            "telephone_number": "303-338-4545"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9139 RIDGELINE BLVD",
            "city": "HIGHLANDS RANCH",
            "state": "CO",
            "postal_code": "801292333",
            "telephone_number": "303-338-4545"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEWIS",
        "first_name": "MICHAEL",
        "middle_name": "N",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-04-29",
        "last_updated": "2012-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CO",
            "license": "991764",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KAISER COMMERCIAL NUMBER",
            "identifier": "021053",
            "state": "CO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "11508078",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Highlands Ranch, CO

Sources for this page

Verify at the official NPI Registry.