Individual provider Active NPI

Kristen M Lewis, FNP

  • Nurse Practitioner
  • Johnson City, NY
National Provider Identifier
1467404152
Registry record updated Jul 20, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
F332667 Issued in NY
Practice address
30 Harrison St
Suite 250
Johnson City, NY 13790
Phone
(607) 770-8600
Fax
(607) 770-0853
NPI assigned
May 17, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 20, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X F332667 NY Primary

Addresses

Primary practice location

30 Harrison St
Suite 250
Johnson City, NY 13790

Mailing address

30 Harrison St
Suite 250
Johnson City, NY 13790
Phone (607) 770-8600

Other identifiers 1

IdentifierTypeStateIssuer
01976214MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20100901000400 NY Practitioner - Nurse Practitioner 3870617517 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
United Medical Associates PCGroup PAC ID 0345144978, 229 clinicians

Practice addresses (Care Compare)

30 Harrison St
Suite 101
Johnson City, NY 13790-2161
Phone (607) 763-8181

33 -57 Harrison St
Johnson City, NY 13790-2107
Phone (607) 763-6622

Hospital & facility affiliations

  • United Health Services Hospitals, Inc Hospital, Binghamton, NY, CCN 330394
  • Chenango Memorial Hospital Hospital, Norwich, NY, CCN 330033
  • Delaware Valley Hospital, Inc Hospital, Walton, NY, CCN 331312

Merit-based Incentive Payment System (MIPS)

Final score
87.59 of 100Reported as group
Quality
78.3
Promoting interoperability
100
Improvement activities
40
Cost
72.17

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
F332667NYMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
United Medical Associates PC CurrentSince Aug 1, 2016 Accepting new patients
United Medical Associates, P.C. CurrentSince Aug 1, 2016 Accepting new patients
United Health Services Hospitals, Inc. CurrentSince Aug 1, 2016 Accepting new patients

Locations

30 Harrison St
Ste 250
Johnson City, NY 13790
Phone (607) 763-6580

33-57 Harrison St
Johnson City, NY 13790
Phone (607) 763-6412

179 River St
Oneonta, NY 13820
Phone (607) 432-8477

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.

Hospital & facility affiliations 4

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": "1147824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1468972800000",
    "number": "1467404152",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 HARRISON ST",
            "address_2": "SUITE 250",
            "city": "JOHNSON CITY",
            "state": "NY",
            "postal_code": "13790",
            "telephone_number": "607-770-8600",
            "fax_number": "607-770-0853"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 HARRISON ST",
            "address_2": "SUITE 250",
            "city": "JOHNSON CITY",
            "state": "NY",
            "postal_code": "13790",
            "telephone_number": "607-770-8600",
            "fax_number": "607-770-0853"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEWIS",
        "first_name": "KRISTEN",
        "middle_name": "M",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-17",
        "last_updated": "2016-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NY",
            "license": "F332667",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01976214",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Johnson City, NY

Sources for this page

Verify at the official NPI Registry.