Kyle Lewis, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA60520595 Issued in WA

Practice address

11216 Sunrise Blvd E
Ste 3-207
Puyallup, WA 98374-8848

Phone

(253) 770-3700

Fax

(253) 435-7019

NPI assigned

Jan 26, 2015

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in WA

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: klewis21006@direct.seattlechildrens.org

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.

• Seattle Children's Hospital

  • Specialist
  • Seattle, WA
  • NPI 1003319500
  Medicare reassignment
• Seattle Childrens Hospital

  dba Seattle Childrens Outpatient Pharmacy

  • Clinic Pharmacy
  • Seattle, WA
  • NPI 1245342153
  NPD
• Digestive Health Specialists PS

  • Gastroenterology Physician
  • Kent, WA
  • NPI 1710149802
  NPD (past)
• Seattle Children's Hospital

  • Home Infusion Agency
  • Bothell, WA
  • NPI 1245383348
  NPD (past)
• Washington Gastroenterology PLLC

  • Gastroenterology Physician
  • Tacoma, WA
  • NPI 1306364401
  NPD (past)
• Washington Gastroenterology PLLC

  dba Washington Gastroenterology Lab

  • Clinical Medical Laboratory
  • Federal Way, WA
  • NPI 1467011122
  NPD (past)

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

{
    "created_epoch": "1422230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1443484800000",
    "number": "1457741688",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3209 S 23RD ST",
            "address_2": "STE 340",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984051602",
            "telephone_number": "253-503-2598",
            "fax_number": "253-404-0506"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11216 SUNRISE BLVD E",
            "address_2": "STE 3-207",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983748848",
            "telephone_number": "253-770-3700",
            "fax_number": "253-435-7019"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEWIS",
        "first_name": "KYLE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-01-26",
        "last_updated": "2015-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "WA",
            "license": "PA60520595",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2042164",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Alana Ann Lewis
• Amanda Josette Lewis
• Jean Marie Lewis, M. ED, LMHCA
• Kevin S Lewis, PAC
• Kiera Lynn Lewis, COTA
• Stephany Rose Lewis, L.M.P.
• Timothy Paul Lewis
• Kathleen Leyba
• Jieying Li
• Jinzheng Li, DO

• Medical Physician Assistant in Puyallup, WA
• Providers in Puyallup, WA by specialty
• Medical Physician Assistant in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.