Individual provider Active NPI

Kari R Lewis, PA-C

  • Physician Assistant
  • Springfield, IL
National Provider Identifier
1437553906
Registry record updated Oct 23, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
085.005118 Issued in IL
Practice address
400 N 9TH St FL 3
Springfield, IL 62702-5310
Phone
(217) 545-8000
Fax
(217) 545-7696
NPI assigned
Oct 13, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 23, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 085.005118 IL Primary

Addresses

Primary practice location

400 N 9TH St FL 3
Springfield, IL 62702-5310

Mailing address

PO Box 19639
Springfield, IL 62794-9639
Phone (217) 545-8000

Other practice location 1

241 W Weaver Rd
Suite 145B
Forsyth, IL 62535-9762
Phone (217) 876-5200

Other practice location 2

702 W Chestnut St
Bloomington, IL 61701-2814
Phone (309) 557-1400

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: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20141230001975 IL Practitioner - Physician Assistant 1658694484 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Siu Physicians and Surgeons IncGroup PAC ID 2365352820, 316 clinicians

Practice addresses (Care Compare)

415 N 9TH St
Springfield, IL 62702-5303
Phone (217) 545-5817

751 N Rutledge St
Springfield, IL 62702-4968
Phone (217) 545-8000

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
085.005118ILMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Board of Trustees of Southern Illinois University Current Accepting new patients
Siu Physicians & Surgeons, Inc CurrentSince Nov 1, 2023 Accepting new patients
Community Health Improvement Center CurrentSince Feb 18, 2017 Accepting new patients
Siu Physicians & Surgeons, Inc CurrentSince Nov 1, 2023 Accepting new patients
Community Health Improvement Center CurrentSince Feb 18, 2017 Accepting new patients
Siu Physicians & Surgeons, Inc Past Accepting new patients

Locations

320 E Central Ave
Decatur, IL 62521
Phone (217) 877-4694

2 Memorial Dr
Fl 2
Decatur, IL 62526

2300 N Edward St
Decatur, IL 62526
Phone (217) 876-3000

400 N 9th St
Fl 3
Springfield, IL 62702

751 N Rutledge St
Springfield, IL 62702
Phone (217) 545-0182

Interoperability endpoints

  • Direct secure messaging: karilewis@siusm.allscriptsdirect.net

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1413158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698019200000",
    "number": "1437553906",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 19639",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627949639",
            "telephone_number": "217-545-8000",
            "fax_number": "217-545-2101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 N 9TH ST FL 3",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627025310",
            "telephone_number": "217-545-8000",
            "fax_number": "217-545-7696"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "241 W Weaver Rd",
            "address_2": "Suite 145B",
            "address_purpose": "LOCATION",
            "city": "Forsyth",
            "state": "IL",
            "postal_code": "625359762",
            "country_code": "US",
            "telephone_number": "217-876-5200",
            "fax_number": "217-876-5226",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "702 W Chestnut St",
            "address_purpose": "LOCATION",
            "city": "Bloomington",
            "state": "IL",
            "postal_code": "617012814",
            "country_code": "US",
            "telephone_number": "309-557-1400",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEWIS",
        "first_name": "KARI",
        "middle_name": "R",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-10-13",
        "last_updated": "2023-10-23",
        "certification_date": "2023-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085.005118",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, IL

Sources for this page

Verify at the official NPI Registry.