Mallory Diane Lewis, DO

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

OS17878 Issued in FL

Practice address

3754 Highway 90 Ste 300
Pace, FL 32571-1098

Phone

(850) 416-5510

NPI assigned

Jun 2, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Mallory Diane Streiffert Former name

Medicare fee-for-service enrollment

Enrolled in FL, HI2 enrollments

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 2

Specialty

Family Practice

Education

University of North Texas HSC, College of Osteopathic Med, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Hawaii Permanente Medical Group IncGroup PAC ID 7618880667, 705 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Kaiser Foundation Hospital Hospital, Honolulu, HI, CCN 120011
• Sacred Heart Hospital Hospital, Pensacola, FL, CCN 100025

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mallory.lewis.1@9582.direct.athenahealth.com

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.

• Hawaii Permanente Medical Group Inc

  • Health Maintenance Organization
  • Honolulu, HI
  • NPI 1710945969
  Medicare reassignment Care Compare group NPD
• Sacred Heart Health System, Inc.

  dba Ascension Medical Group Sacred Heart

  • Ambulatory Family Planning Facility
  • Pensacola, FL
  • NPI 1962453308
  Medicare reassignment NPD
• Sacred Heart Health System Inc

  dba Ascension Rx 1411

  • Community/Retail Pharmacy
  • Pensacola, FL
  • NPI 1366260739
  NPD
• Sacred Heart Health System, Inc.

  dba Ascension Medical Group Sacred Heart

  • Family Medicine Physician
  • Pensacola, FL
  • NPI 1144271586
  NPD

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

• Sacred Heart Health System, Inc.

  dba Ascension Sacred Heart Pensacola

  • General Acute Care Hospital
  • Pensacola, FL
  • NPI 1922032424
  Care Compare affiliation
• Kaiser Foundation Hospitals

  • General Acute Care Hospital
  • Honolulu, HI
  • NPI 1396813861
  Care Compare affiliation

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

{
    "created_epoch": "1496361600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631491200000",
    "number": "1588192520",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4205 BELFORT RD STE 4015",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322163623",
            "telephone_number": "904-450-6063",
            "fax_number": "904-539-4091"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3754 HIGHWAY 90 STE 300",
            "city": "PACE",
            "state": "FL",
            "postal_code": "325711098",
            "telephone_number": "850-416-5510"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEWIS",
        "first_name": "MALLORY",
        "middle_name": "DIANE",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-02",
        "last_updated": "2021-09-13",
        "certification_date": "2021-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "FL",
            "license": "OS17878",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "OS17878",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MALLORY",
            "last_name": "STREIFFERT",
            "middle_name": "DIANE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Sandie Joyce Leonard, MA
• Michael Paul Levaugh, ARNP
• Kathaleen Cecile Levings, DPT
• Breacious Senquae Lewis
• Janet I Lewis, M.D.
• Emily Lieser, CPNP-PC
• Erin Light
• Erin Lind, DNP, FNP-BC
• Kristen E Lindsey, RBT
• Katie Linville, RDN

• Family Medicine Physician in Pace, FL
• Providers in Pace, FL by specialty
• Family Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.