Individual provider Active NPI

Michael Lewis, DO

  • Family Medicine Physician
  • Indianapolis, IN
National Provider Identifier
1487189510
Registry record updated Nov 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
02005571A Issued in IN
Practice address
5908 E Stop 11 Rd
Indianapolis, IN 46237-8683
Phone
(317) 497-6800
Fax
(317) 497-6801
NPI assigned
Apr 26, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 21, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X 11019586A IN
Family Medicine Physician 207Q00000X 02005571A IN Primary

Addresses

Primary practice location

5908 E Stop 11 Rd
Indianapolis, IN 46237-8683

Mailing address

6626 E 75TH St
Suite 500
Indianapolis, IN 46250-2805

Other practice location 1

10122 E 10th St
Suite 100
Indianapolis, IN 46229-2663
Phone (317) 355-5717

Other identifiers 1

IdentifierTypeStateIssuer
Q00369280OtherINRAILROAD MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20200821002785 IN Practitioner - Family Practice 7012286552 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Community Physicians of Indiana IncGroup PAC ID 1759416662, 1,569 clinicians

Practice addresses (Care Compare)

5908 E Stop 11 Rd
Indianapolis, IN 46237-8683
Phone (317) 497-6800

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Community Physicians of Indiana Inc CurrentSince Sep 21, 2020 Accepting new patients
Community Physicians of Indiana Inc Family Medicine CurrentSince Sep 21, 2020 Accepting new patients
Major Hospital Past Accepting new patients

Locations

5819 Reliable Pkwy
Chicago, IL 60686

7120 Clearvista Dr
Ste 4000
Indianapolis, IN 46256
Phone (317) 621-7444

10122 E 10th St
Ste 100
Indianapolis, IN 46229
Phone (317) 355-5717

5545 E Stop 11 Rd
Indianapolis, IN 46237
Phone (317) 497-6800

5908 E Stop 11 Rd
Indianapolis, IN 46237
Phone (317) 497-6800

6626 E 75th St
Ste 500
Indianapolis, IN 46250
Phone (317) 621-7547

Interoperability endpoints

  • Direct secure messaging: mlewis164559@ecommunitydirect.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 5

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": "1493164800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668988800000",
    "number": "1487189510",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6626 E 75TH ST",
            "address_2": "SUITE 500",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462502805"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5908 E STOP 11 RD",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462378683",
            "telephone_number": "317-497-6800",
            "fax_number": "317-497-6801"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10122 E 10th St",
            "address_2": "Suite 100",
            "address_purpose": "LOCATION",
            "city": "Indianapolis",
            "state": "IN",
            "postal_code": "462292663",
            "country_code": "US",
            "telephone_number": "317-355-5717",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEWIS",
        "first_name": "MICHAEL",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-04-26",
        "last_updated": "2022-11-21",
        "certification_date": "2022-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "IN",
            "license": "11019586A",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "02005571A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "Q00369280",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.