Individual provider Active NPI

Daniel Gene Lewis, M.D.

  • Obstetrics & Gynecology Physician
  • Lakeport, CA
National Provider Identifier
1457390155
Registry record updated Sep 14, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
DL054034 Issued in MI
Practice address
1971 Riggs Rd
Lakeport, CA 95453-8736
Phone
(707) 533-9177
NPI assigned
Jun 6, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 14, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X DL054034 MI Primary

Addresses

Primary practice location

1971 Riggs Rd
Lakeport, CA 95453-8736

Mailing address

1971 Riggs Road
Lakeport, CA 95453
Phone (707) 533-9177

Other identifiers 1

IdentifierTypeStateIssuer
102779090MedicaidMI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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 1

Enrollment IDStateProvider typePAC IDDetails
I20100324000664 CA Practitioner - Obstetrics/Gynecology 3072553676 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
DL054034MIMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lake County Tribal Health Consortium Inc. CurrentSince Aug 19, 2024 Accepting new patients
Lake County Tribal Health Southshore Clinic CurrentSince Aug 19, 2024 Accepting new patients
Radiology Associates of Berrien County PC Past Accepting new patients

Locations

14440 Olympic Dr
Clearlake, CA 95422
Phone (707) 263-8382

925 Bevins Ct
Lakeport, CA 95453
Phone (707) 263-8382

Interoperability endpoints

  • Direct secure messaging: daniel.lewis.p1@direct.lcthc.nextgenshare.com
  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 3

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": "1149552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1505347200000",
    "number": "1457390155",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1971 RIGGS ROAD",
            "city": "LAKEPORT",
            "state": "CA",
            "postal_code": "95453",
            "telephone_number": "707-533-9177"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1971 RIGGS RD",
            "city": "LAKEPORT",
            "state": "CA",
            "postal_code": "954538736",
            "telephone_number": "707-533-9177"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEWIS",
        "first_name": "DANIEL",
        "middle_name": "GENE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-06",
        "last_updated": "2017-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "MI",
            "license": "DL054034",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "102779090",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakeport, CA

Sources for this page

Verify at the official NPI Registry.