Individual provider Active NPI

Tyler Lewandowski, DO

  • Emergency Medicine Physician
  • Erie, PA
National Provider Identifier
1447697925
Registry record updated Oct 5, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
OS017205 Issued in PA
Practice address
201 State St
Erie, PA 16550-0002
Phone
(814) 877-6000
NPI assigned
May 24, 2013
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 5, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X OT015305 PA
Emergency Medicine Physician 207P00000X OS017205 PA Primary

Addresses

Primary practice location

201 State St
Erie, PA 16550-0002

Mailing address

201 State St
Erie, PA 16550-0002
Phone (814) 877-6000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE, IA2 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
I20170530000034 NE Practitioner - Emergency Medicine 5991922635 Reassigns benefits to 1 organization
I20170614000938 IA Practitioner - Emergency Medicine 5991922635

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Emergency Clinicians Associates, LLCGroup PAC ID 3476511619, 15 clinicians

Practice addresses (Care Compare)

6901 N 72ND St
Omaha, NE 68122-1709
Phone (402) 572-2121

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
OS017205PAMDEmergency Medicine Physician
1623NEMDSpeech-Language Pathologist
OT015305PAMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
New Century Physicians of Nebraska LLC Emergency Medicine CurrentSince Jul 1, 2017 Accepting new patients
Emergency Clinicians Associates, LLC CurrentSince Jun 18, 2019 Accepting new patients
New Century Physicians of Nebraska LLC Emergency Medicine Current Accepting new patients
New Century Physicians of Iowa PC Emergency Medicine CurrentSince Jul 1, 2017 Accepting new patients

Locations

800 Mercy Dr
Council Bluffs, IA 51503
Phone (712) 328-5000

16901 Lakeside Hills Ct
Omaha, NE 68130
Phone (402) 572-6500

6901 N 72nd St
Omaha, NE 68122
Phone (402) 572-2121

11111 S 84th St
Papillion, NE 68046
Phone (402) 593-3000

Organizations & group practices 4

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1369353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1475625600000",
    "number": "1447697925",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 STATE ST",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165500002",
            "telephone_number": "814-877-6000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 STATE ST",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165500002",
            "telephone_number": "814-877-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEWANDOWSKI",
        "first_name": "TYLER",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-05-24",
        "last_updated": "2016-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "PA",
            "license": "OT015305",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "PA",
            "license": "OS017205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Erie, PA

Sources for this page

Verify at the official NPI Registry.