Individual provider Active NPI

Lewis Nelson, M.D.

  • Emergency Medicine Physician
  • Boca Raton, FL
National Provider Identifier
1639164635
Registry record updated Mar 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
ME171142 Issued in NJ
Practice address
777 Glades Rd # BC-71
Boca Raton, FL 33431-6496
Phone
(561) 297-0133
NPI assigned
Sep 15, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 29, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Toxicology (Emergency Medicine) Physician 207PT0002X ME171142 NJ
Emergency Medicine Physician 207P00000X ME171142 NJ Primary

Addresses

Primary practice location

777 Glades Rd # BC-71
Boca Raton, FL 33431-6496

Mailing address

777 Glades Rd # BC-71
Boca Raton, FL 33431-6496
Phone (561) 297-0133

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ, FL2 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

Enrollment IDStateProvider typePAC IDDetails
I20161102002327 NJ Practitioner - Emergency Medicine 5092991091 Reassigns benefits to 1 organization
I20250813003586 FL Practitioner - Emergency Medicine 5092991091 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1643 NW 136 Ave
Sunrise, FL 33323-2857

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME171142NJMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Paragon Contracting Services LLC Emergency Medicine CurrentSince Jul 6, 2025 Accepting new patients
University Physician Associates of New Jersey Inc Emergency Medicine CurrentSince Sep 11, 2016 Accepting new patients
University Physician Associates of New Jersey Inc Emergency Medicine CurrentSince Sep 11, 2016 Accepting new patients

Locations

2815 S Seacrest Blvd
Boynton Beach, FL 33435
Phone (561) 732-1277

9655 Boynton Beach Blvd
Boynton Beach, FL 33472
Phone (561) 336-7000

901 45th St
Mangonia Park, FL 33407
Phone (561) 844-6300

1643 NW 136th Ave
Ste 100
Sunrise, FL 33323
Phone (865) 500-1325

150 Bergen St
Newark, NJ 07103
Phone (973) 972-6056

30 Bergen St
Rm 1205
Newark, NJ 07107
Phone (973) 972-0037

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Rutgers Health - University Behavioral Health CarePiscataway, NJ, CCN 314011 Hospital Corporate Director Jul 1, 2017

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 3

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.

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": "1126742400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743206400000",
    "number": "1639164635",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "777 GLADES RD # BC-71",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334316496",
            "telephone_number": "561-297-0133"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "777 GLADES RD # BC-71",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334316496",
            "telephone_number": "561-297-0133"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NELSON",
        "first_name": "LEWIS",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-15",
        "last_updated": "2025-03-29",
        "certification_date": "2025-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207PT0002X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Medical Toxicology",
            "state": "NJ",
            "license": "ME171142",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NJ",
            "license": "ME171142",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boca Raton, FL

Sources for this page

Verify at the official NPI Registry.