Individual provider Active NPI

Scott A Lewis, PA-C

  • Medical Physician Assistant
  • Tallahassee, FL
National Provider Identifier
1609847714
Registry record updated Jan 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA9109674 Issued in FL
Practice address
2000 Centre Pointe Blvd
Tallahassee, FL 32308-4894
Phone
(850) 309-0400
NPI assigned
Jan 27, 2006
Last updated
Jan 11, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 11, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA9109674 FL Primary
Medical Physician Assistant 363AM0700X 003402 GA

Addresses

Primary practice location

2000 Centre Pointe Blvd
Tallahassee, FL 32308-4894

Mailing address

12109 County Road 103
Oxford, FL 34484-2951
Phone (352) 205-8981

Other identifiers 4

IdentifierTypeStateIssuer
295460765CMedicaidGA
295460765DMedicaidGA
533798OtherGAWELLCARE
295460765AMedicaidGA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA, FL2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20050914000139 GA Practitioner - Physician Assistant 6709819428 Reassigns benefits to 3 organizations
I20180524002634 FL Practitioner - Physician Assistant 6709819428 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Advanced Urology Institute LLCGroup PAC ID 2163653585, 152 clinicians

Practice addresses (Care Compare)

2000 Centre Pointe Blvd
Tallahassee, FL 32308-4894
Phone (850) 309-0400

609 W Highland Blvd
Inverness, FL 34452-4638
Phone (352) 726-9707

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
003402GAMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Urology Institute, LLC CurrentSince Jan 18, 2018 Accepting new patients
John D Archbold Memorial Hospital Inc CurrentSince Jun 1, 2021 Accepting new patients
Pathology Associates, P.C. Current Accepting new patients
Advanced Urology Institute, LLC CurrentSince Jan 18, 2018 Accepting new patients
Hospital Authority of the City of Bainbridge and Decatur County Past Accepting new patients
Advanced Urology Institute LLC Past Accepting new patients

Locations

609 W Highland Blvd
Inverness, FL 34452
Phone (352) 726-9707

12109 County Road 103
Oxford, FL 34484
Phone (352) 205-8981

2000 Centre Pointe Blvd
Tallahassee, FL 32308
Phone (850) 309-0400

100 Mimosa Dr
Thomasville, GA 31792
Phone (229) 226-9141

100 Mimosa Dr
Ste 1R
Thomasville, GA 31792
Phone (229) 226-9141

114 Mimosa Dr
Ste A
Thomasville, GA 31792
Phone (229) 227-1595

510 Gordon Ave
Thomasville, GA 31792
Phone (229) 227-1997

915 Gordon Ave
Thomasville, GA 31792
Phone (229) 228-8575

920 Cairo Rd
Thomasville, GA 31792
Phone (229) 228-8800

Interoperability endpoints

  • FHIR API: https://app.meldrx.com/api/fhir/uc41222_advuroswflorida

Organizations & group practices 7

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 1

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": "1138320000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610323200000",
    "number": "1609847714",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12109 COUNTY ROAD 103",
            "city": "OXFORD",
            "state": "FL",
            "postal_code": "344842951",
            "telephone_number": "352-205-8981"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 CENTRE POINTE BLVD",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323084894",
            "telephone_number": "850-309-0400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEWIS",
        "first_name": "SCOTT",
        "middle_name": "A",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-27",
        "last_updated": "2021-01-11",
        "certification_date": "2021-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "FL",
            "license": "PA9109674",
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "GA",
            "license": "003402",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "295460765C",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "295460765D",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLCARE",
            "identifier": "533798",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "295460765A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tallahassee, FL

Sources for this page

Verify at the official NPI Registry.