Anna Klaertje Lewis, M.D.
Individual provider Active NPI Family Medicine Physician · Polacca, AZ
NPI 1467599183 · NPPES record last updated Dec 20, 2021
Key facts
- NPI
- 1467599183
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 31956 (AZ)
- Practice address
- Hwy 264, Mile Post 388
Polacca, AZ 86042 - Phone
- (928) 737-6148
- NPI assigned
- Jan 31, 2007
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 3
Hospital & facility affiliations 2
Medicare Care Compare profile
- Specialty
- Family Practice
- Education
- University of Vermont College of Medicine, 2000
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Permanente Medical Group Inc
Practice addresses (Care Compare)
7373 W Lane
Stockton, CA 95210-3377
Phone (209) 476-2000
Hospital & facility affiliations
- By the Bay Health
- Kaiser Foundation Hospital-Santa Rosa
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20111215000507 | CA | Practitioner - Family Practice | 9739089590 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Permanente Medical Group, Inc | Current |
Accepting new patients | |
| Permanente Medical Group Inc | Family Medicine | Current |
Accepting new patients |
Locations
1800 Harrison St
Fl 7
Oakland, CA 94612
1150 Veterans Blvd
Redwood City, CA 94063
Phone (650) 299-2015
901 Nevin Ave
Richmond, CA 94801
Phone (510) 307-1500
2200 Ofarrell St
San Francisco, CA 94115
Phone (415) 202-2000
710 Lawrence Expy
Santa Clara, CA 95051
Phone (408) 236-6400
7373 West Ln
Stockton, CA 95210
Phone (209) 476-2000
975 Sereno Dr
Vallejo, CA 94589
Phone (707) 651-1000
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 31956 | AZ | Yes |
Addresses
Primary practice location
Hwy 264, Mile Post 388
Polacca, AZ 86042
Mailing address
PO Box 942
Polacca, AZ 86042-0942
Phone (928) 737-6148
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 809361 | Medicaid | AZ |
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| SOAP URL | https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq | Health Information Exchange (HIE) | The Permanente Medical Group |
Other providers in Polacca, AZ
- Gina Marie Kosek
- Nancy Kramer
- Stanley Kurley Jr.
- Erica Lalo
- Han Le
- Susan Lippold
- Marti E. Loew
- Troy Leon Lomavaya
- Beth L Love
- Daniel C Lyons
All providers in Polacca, AZ · Family Medicine Physician in Arizona
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 20, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.