Individual provider Active NPI

Matthew T. Lewis, M.D.

  • Diagnostic Radiology Physician
  • Mount Kisco, NY
National Provider Identifier
1639335292
Registry record updated Jan 25, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
244250-1 Issued in NY
Practice address
90 S Bedford Rd
Mount Kisco, NY 10549-3412
Phone
(188) 865-6472
NPI assigned
Aug 4, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 25, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 244250-1 NY Primary

Addresses

Primary practice location

90 S Bedford Rd
Mount Kisco, NY 10549-3412

Mailing address

109 Guilford Schoolhouse Rd
New Paltz, NY 12561-3532
Phone (347) 907-4832

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, NJ2 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
I20100727000652 NY Practitioner - Diagnostic Radiology 4789717851 Reassigns benefits to 2 organizations
I20230126001111 NJ Practitioner - Diagnostic Radiology 4789717851 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
St. Louis College of Physicians and Surgeons, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Optum Medical Care PCGroup PAC ID 9931013240, 1,013 clinicians

Practice addresses (Care Compare)

90 S Bedford Rd
Mount Kisco, NY 10549-3412
Phone (914) 241-1050

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
244250-1NYMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Optum Urgent Care, PLLC CurrentSince Mar 1, 2025 Accepting new patients
Optum Medical Care, P.C. CurrentSince Sep 21, 2024 Accepting new patients
Optum Medical Care, P.C. Diagnostic Radiology CurrentSince Sep 21, 2024 Accepting new patients
Optum Medical Care of New Jersey PC CurrentSince Nov 1, 2023 Accepting new patients
A.G. Dikengil, MD, PA CurrentSince Jan 1, 2023 Accepting new patients
Optum Medical Care of New Jersey PC CurrentSince Nov 1, 2023 Accepting new patients
First Med PA Past Accepting new patients

Locations

935 River Rd
Ste 301
Edgewater, NJ 07020
Phone (201) 471-7012

736 Page Ave
Lyndhurst, NJ 07071
Phone (201) 531-9006

1 Harmon Plz
Fl 10
Secaucus, NJ 07094
Phone (201) 636-7233

2322 30th Ave
Astoria, NY 11102
Phone (718) 267-2763

555 N Broadway
Jericho, NY 11753
Phone (516) 597-5070

110 S Bedford Rd
Mount Kisco, NY 10549
Phone (763) 910-9192

90 S Bedford Rd
Mount Kisco, NY 10549
Phone (914) 242-1050

Philadelphia, PA 19195

Networks

  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678

Interoperability endpoints

  • Direct secure messaging: mlewis144534@direct.optum.com

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1217808000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1295913600000",
    "number": "1639335292",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "109 GUILFORD SCHOOLHOUSE RD",
            "city": "NEW PALTZ",
            "state": "NY",
            "postal_code": "125613532",
            "telephone_number": "347-907-4832"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "90 S BEDFORD RD",
            "city": "MOUNT KISCO",
            "state": "NY",
            "postal_code": "105493412",
            "telephone_number": "188-865-6472"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEWIS",
        "first_name": "MATTHEW",
        "middle_name": "T.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-08-04",
        "last_updated": "2011-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NY",
            "license": "244250-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Kisco, NY

Sources for this page

Verify at the official NPI Registry.