Individual provider Active NPI

Yuri Lewicky, M.D.

  • Sports Medicine (Orthopaedic Surgery) Physician
  • Flagstaff, AZ
National Provider Identifier
1467454702
Registry record updated Sep 27, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Orthopaedic Surgery) PhysicianTaxonomy code 207XX0005X
License
33479 Issued in AZ
Practice address
1485 N Turquoise Dr
Suite 200
Flagstaff, AZ 86001-1398
Phone
(928) 774-7757
Fax
(928) 774-7767
NPI assigned
Jun 1, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Orthopaedic Surgery) Physician 207XX0005X 33479 AZ Primary

Addresses

Primary practice location

1485 N Turquoise Dr
Suite 200
Flagstaff, AZ 86001-1398

Mailing address

1485 N Turquoise Drive
Flagstaff, AZ 86001
Phone (928) 774-4460

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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
I20060109000141 AZ Practitioner - Orthopedic Surgery 6800824525 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
University of Arizona College of Medicine, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Center for Orthopedic Research and Education LLCGroup PAC ID 0345287322, 247 clinicians

Practice addresses (Care Compare)

18444 N 25TH Ave
Suite 210
Phoenix, AZ 85023-1264
Phone (866) 974-2673

Hospital & facility affiliations

  • Flagstaff Medical Center Hospital, Flagstaff, AZ, CCN 030023
  • Verde Valley Medical Center Hospital, Cottonwood, AZ, CCN 030007
  • Yavapai Regional Medical Center Hospital, Prescott, AZ, CCN 030012

Merit-based Incentive Payment System (MIPS)

Final score
85.65 of 100Reported as group
Quality
76.23
Promoting interoperability
100
Improvement activities
40
Cost
75.95

Procedures performed for Medicare patients

ProcedureNumber of procedures
Lower limb (leg) arthroscopy (minimally invasive joint repair)1-10
Upper limb (arm) arthroscopy (minimally invasive joint repair)82

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
33479AZMDSports Medicine (Orthopaedic Surgery) Physician
90404CAMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Center for Orthopedic Research and Education, LLC Sports Medicine Current Accepting new patients
Center for Orthopedic Research and Education LLC CurrentSince Feb 12, 2021 Accepting new patients
Center for Orthopedic Research and Educatoin CurrentSince Feb 12, 2021 Accepting new patients

Locations

1840 N Jasper Dr
Ste 3
Flagstaff, AZ 86001

1840 N Jasper Dr
Ste 2
Flagstaff, AZ 86001
Phone (928) 226-2900

1485 N Turquoise Dr
Ste 200
Flagstaff, AZ 86001
Phone (928) 774-7757

18444 N 25th Ave
Ste 310
Phoenix, AZ 85023
Phone (623) 241-8706

18444 N 25th Ave
Ste 210
Phoenix, AZ 85023
Phone (669) 742-6738

3200 N Windsong Dr
Prescott Vly, AZ 86314
Phone (928) 226-2900

10494 W Thunderbird Blvd
Ste 102
Sun City, AZ 85351
Phone (623) 975-8311

Interoperability endpoints

  • Direct secure messaging: yuri.lewicky.1@22724.direct.athenahealth.com

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 7

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": "1117584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1506470400000",
    "number": "1467454702",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1485 N TURQUOISE DRIVE",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "86001",
            "telephone_number": "928-774-4460",
            "fax_number": "928-226-3071"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1485 N TURQUOISE DR",
            "address_2": "SUITE 200",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "860011398",
            "telephone_number": "928-774-7757",
            "fax_number": "928-774-7767"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEWICKY",
        "first_name": "YURI",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-01",
        "last_updated": "2017-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207XX0005X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": "AZ",
            "license": "33479",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Flagstaff, AZ

Sources for this page

Verify at the official NPI Registry.