NPIMap

Individual provider Active NPI

Brandon J. Lewis, DPM

  • Podiatrist
  • Grand Prairie, TX
National Provider Identifier
1487654489
Registry record updated Aug 16, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
1574 Issued in TX
Practice address
504 N Carrier Pkwy
Grand Prairie, TX 75050-5428
Phone
(972) 263-7042
Fax
(972) 263-7046
NPI assigned
Aug 1, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 16, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X 1574 TX Primary

Addresses

Primary practice location

504 N Carrier Pkwy
Grand Prairie, TX 75050-5428

Mailing address

504 N Carrier Pkwy
Grand Prairie, TX 75050-5428
Phone (972) 263-7042

Other identifiers 3

IdentifierTypeStateIssuer
P00820670OtherTXGROUP MEMBER INDIVIDUAL RRM PTAN #
8U9330OtherTXBCBS
161998302MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041104001203 TX Practitioner - Podiatry 7810950441 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Kent State University College of Podiatric Medicine, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dallas County Hospital DistrictGroup PAC ID 8325934813, 597 clinicians

Practice addresses (Care Compare)

802 Hopkins St
Garland, TX 75040-7379
Phone (214) 266-0700

Hospital & facility affiliations

  • Parkland Health & Hospital System Hospital, Dallas, TX, CCN 450015

Merit-based Incentive Payment System (MIPS)

Final score
95.1 of 100Reported as group
Quality
88.97
Promoting interoperability
79
Improvement activities
40
Cost
83.75

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10
Removal of skin lesions1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1574TXMDPodiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Dallas County Hospital District Current Accepting new patients
Dallas County Hospital District Podiatrist CurrentSince Apr 5, 2009 Accepting new patients
Dallas County Hospital District CurrentSince Apr 5, 2009 Accepting new patients
Dental Delite PG PA Past Accepting new patients
Dental Delite of Duncanville Past Accepting new patients

Locations

5151 Maple Ave
Fl 4
Dallas, TX 75235
Phone (214) 590-0153

5201 Harry Hines Blvd
Dallas, TX 75235
Phone (214) 590-1396

802 Hopkins St
Garland, TX 75040
Phone (214) 266-0665

1800 N Britain Rd
Irving, TX 75061
Phone (214) 266-3000

Interoperability endpoints

  • Direct secure messaging: blewis7060@direct.phhs.org

Organizations & group practices 6

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 45

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 45

NPI Registry JSON

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

{
    "created_epoch": "1122854400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1281916800000",
    "number": "1487654489",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "504 N CARRIER PKWY",
            "city": "GRAND PRAIRIE",
            "state": "TX",
            "postal_code": "750505428",
            "telephone_number": "972-263-7042",
            "fax_number": "972-263-7046"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "504 N CARRIER PKWY",
            "city": "GRAND PRAIRIE",
            "state": "TX",
            "postal_code": "750505428",
            "telephone_number": "972-263-7042",
            "fax_number": "972-263-7046"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEWIS",
        "first_name": "BRANDON",
        "middle_name": "J.",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-01",
        "last_updated": "2010-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "TX",
            "license": "1574",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP MEMBER INDIVIDUAL RRM PTAN #",
            "identifier": "P00820670",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "8U9330",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "161998302",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Prairie, TX

Sources for this page

Verify at the official NPI Registry.