NPIMap

Individual provider Active NPI

Jared Michael Lewis, PA C

  • Physician Assistant
  • Cape Girardeau, MO
National Provider Identifier
1639611718
Registry record updated Jan 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
2016039248 Issued in MO
Practice address
48 Doctors Park
Cape Girardeau, MO 63703-4928
Phone
(573) 335-8257
Fax
(573) 335-8424
NPI assigned
Nov 7, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 3, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 2016039248 MO Primary

Addresses

Primary practice location

48 Doctors Park
Cape Girardeau, MO 63703-4928

Mailing address

PO Box 801143
Kansas City, MO 64180-1143
Phone (573) 331-5583

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161128000149 MO Practitioner - Physician Assistant 9335428853 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Health Facilities Rehab Services Inc 152 clinicians
Saint Francis Medical Center 441 clinicians

Practice addresses (Care Compare)

1102 Sikes Ave
Sikeston, MO 63801-5021

150 S Mount Auburn Rd
Cape Girardeau, MO 63703-5049

211 Saint Francis Dr
Cape Girardeau, MO 63703-5049

24 S Mount Auburn Rd
Cape Girardeau, MO 63703-5049

48 Doctors Park
Cape Girardeau, MO 63703-4928
Phone (573) 335-8257

70 Doctors Park
Cape Girardeau, MO 63703-4928
Phone (573) 334-6071

Hospital & facility affiliations

  • Saint Francis Medical Center Hospital, Cape Girardeau, MO, CCN 260183

Merit-based Incentive Payment System (MIPS)

Final score
67.07 of 100Reported as apm
Quality
85.4
Promoting interoperability
0
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2016039248MOMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Saint Francis Medical Center CurrentSince Dec 12, 2023 Accepting new patients
Saint Francis Medical Center CurrentSince Dec 12, 2023 Accepting new patients
Saint Francis Medical Center Past Accepting new patients

Locations

48 Doctors Park
Cpe Girardeau, MO 63703
Phone (573) 335-8257

211 Saint Francis Dr
Cpe Girardeau, MO 63703
Phone (573) 331-3000

Interoperability endpoints

  • Direct secure messaging: jlewis105319@surescripts.sfmc.net

Organizations & group practices 22

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.

View all 22

Hospital & facility affiliations 2

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": "1478476800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704240000000",
    "number": "1639611718",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 801143",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641801143",
            "telephone_number": "573-331-5583",
            "fax_number": "573-331-5079"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "48 DOCTORS PARK",
            "city": "CAPE GIRARDEAU",
            "state": "MO",
            "postal_code": "637034928",
            "telephone_number": "573-335-8257",
            "fax_number": "573-335-8424"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEWIS",
        "first_name": "JARED",
        "middle_name": "MICHAEL",
        "credential": "PA C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-11-07",
        "last_updated": "2024-01-03",
        "certification_date": "2024-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MO",
            "license": "2016039248",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cape Girardeau, MO

Sources for this page

Verify at the official NPI Registry.