Individual provider Active NPI

Andrea Lewis, CNS

  • Nurse Practitioner
  • Valparaiso, IN
National Provider Identifier
1568607133
Registry record updated Jun 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
71002853A Issued in IN
Practice address
2711 Leonard Dr Ste 101
Valparaiso, IN 46383-7121
Phone
(219) 462-6001
NPI assigned
Dec 10, 2008
Last updated
Jun 1, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 1, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 71002853A IN Primary

Addresses

Primary practice location

2711 Leonard Dr Ste 101
Valparaiso, IN 46383-7121

Mailing address

120 W 22ND St Ste 200
Oak Brook, IL 60523-1563
Phone (630) 575-5000

Other identifiers 1

IdentifierTypeStateIssuer
200933130MedicaidIN

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address credentialing@nephdocs.com

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090427000379 IN Practitioner - Certified Clinical Nurse Specialist (CNS) 9234287400 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Clinical Nurse Specialist (CNS)
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Nephrology Associates of Northern Indiana PCGroup PAC ID 8921033440, 64 clinicians

Practice addresses (Care Compare)

1705 W 25TH Ave
Suite 102
Gary, IN 46404-3544
Phone (219) 844-2011

2711 Leonard Dr
Suite 101
Valparaiso, IN 46383-7121
Phone (219) 462-6001

569 Tyler St
Gary, IN 46402-1829
Phone (260) 885-3300

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Specialist, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
71002853AINMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Nephrology Associates of Northern Indiana, Inc CurrentSince Apr 1, 2020 Accepting new patients
Nephrology Specialists, PC. Past Accepting new patients

Locations

120 W 22nd St
Ste 200
Oak Brook, IL 60523
Phone (630) 575-5000

650 Dickinson Rd
Chesterton, IN 46304
Phone 21926346008228

569 Tyler St
Gary, IN 46402
Phone (260) 885-3300

90 W 86th Ave
Merrillville, IN 46410
Phone (219) 791-1555

2711 Leonard Dr
#101
Valparaiso, IN 46383
Phone (219) 432-6001

Interoperability endpoints

  • Direct secure messaging: alewis41351@direct.acumenmd.com
  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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 2

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": "1228867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654041600000",
    "number": "1568607133",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 W 22ND ST STE 200",
            "city": "OAK BROOK",
            "state": "IL",
            "postal_code": "605231563",
            "telephone_number": "630-575-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2711 LEONARD DR STE 101",
            "city": "VALPARAISO",
            "state": "IN",
            "postal_code": "463837121",
            "telephone_number": "219-462-6001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEWIS",
        "first_name": "ANDREA",
        "credential": "CNS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-12-10",
        "last_updated": "2022-06-01",
        "certification_date": "2022-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IN",
            "license": "71002853A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200933130",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "credentialing@nephdocs.com",
            "affiliation": "N",
            "address_1": "120 W 22nd St Ste 200",
            "city": "Oak Brook",
            "state": "IL",
            "country_code": "US",
            "postal_code": "605231563",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Valparaiso, IN

Sources for this page

Verify at the official NPI Registry.