Individual provider Active NPI

Medita L Lewis, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Northampton, MA
National Provider Identifier
1619584091
Registry record updated Sep 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
RN2307676 Issued in MA
Practice address
8 Atwood Dr Ste 201
Northampton, MA 01060-4266
Phone
(413) 582-0471
NPI assigned
Sep 29, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 2, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN2307676 MA
Psychiatric/Mental Health Nurse Practitioner 363LP0808X RN2307676 MA Primary

Addresses

Primary practice location

8 Atwood Dr Ste 201
Northampton, MA 01060-4266

Mailing address

8 Atwood Dr Ste 201
Northampton, MA 01060-4266
Phone (413) 582-0471

Other names 1

  • Medita Lewis Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20211202001302 MA Practitioner - Nurse Practitioner 7911397138 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Clinical and Support Options, IncGroup PAC ID 6608835350, 103 clinicians

Practice addresses (Care Compare)

8 Atwood Dr
Northampton, MA 01060-4266
Phone (413) 582-0471

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN2307676MAMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Clinical & Support Options, Inc CurrentSince Sep 20, 2021 Accepting new patients

Locations

1 Arch Pl
Greenfield, MA 01301
Phone (413) 773-1000

8 Atwood Dr
Ste 201
Northampton, MA 01060
Phone (413) 528-0471

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1601337600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630540800000",
    "number": "1619584091",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8 ATWOOD DR STE 201",
            "city": "NORTHAMPTON",
            "state": "MA",
            "postal_code": "010604266",
            "telephone_number": "413-582-0471"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8 ATWOOD DR STE 201",
            "city": "NORTHAMPTON",
            "state": "MA",
            "postal_code": "010604266",
            "telephone_number": "413-582-0471"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEWIS",
        "first_name": "MEDITA",
        "middle_name": "L",
        "credential": "PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-09-29",
        "last_updated": "2021-09-02",
        "certification_date": "2021-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MA",
            "license": "RN2307676",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MA",
            "license": "RN2307676",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MEDITA",
            "last_name": "LEWIS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Northampton, MA

Sources for this page

Verify at the official NPI Registry.