Individual provider Active NPI

Raja Edmon Lewis, MD

  • Internal Medicine Physician
  • Sterling Heights, MI
National Provider Identifier
1558479469
Registry record updated Sep 18, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
430107257 Issued in MI
Practice address
3840 17 Mile Rd
Raja Lewis
Sterling Heights, MI 48310-6831
Phone
(586) 826-9625
Fax
(586) 826-9622
NPI assigned
Aug 29, 2006
Last updated
Sep 18, 2014By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 18, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 430107257 MI Primary

Addresses

Primary practice location

3840 17 Mile Rd
Raja Lewis
Sterling Heights, MI 48310-6831

Mailing address

3840 17 Mile Rd
Raja Lewis
Sterling Heights, MI 48310-6831
Phone (586) 826-9625

Other identifiers 1

IdentifierTypeStateIssuer
4390307MedicaidMI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20040527000628 MI Practitioner - Internal Medicine 1658362975 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

3840 17 Mile Rd
Sterling Heights, MI 48310-6831
Phone (586) 826-9625

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
430107257MIMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Raja Lewis MD PC Internal Medicine CurrentSince Sep 1, 2003 Accepting new patients
Mahmoud Alhadidi MD PC Past Accepting new patients

Locations

33164 Ryan Rd
Sterling Hts, MI 48310
Phone (248) 879-1416

3840 17 Mile Rd
Sterling Hts, MI 48310
Phone (586) 826-9625

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1156809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1410998400000",
    "number": "1558479469",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3840 17 MILE RD",
            "address_2": "RAJA LEWIS",
            "city": "STERLING HEIGHTS",
            "state": "MI",
            "postal_code": "483106831",
            "telephone_number": "586-826-9625",
            "fax_number": "586-826-9622"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3840 17 MILE RD",
            "address_2": "RAJA LEWIS",
            "city": "STERLING HEIGHTS",
            "state": "MI",
            "postal_code": "483106831",
            "telephone_number": "586-826-9625",
            "fax_number": "586-826-9622"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEWIS",
        "first_name": "RAJA",
        "middle_name": "EDMON",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-29",
        "last_updated": "2014-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "430107257",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4390307",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sterling Heights, MI

Sources for this page

Verify at the official NPI Registry.