Individual provider Active NPI

Keaton M Lewis, DPT

  • Physical Therapist
  • Bellevue, NE
National Provider Identifier
1679208268
Registry record updated Sep 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
4342 Issued in NE
Practice address
555 Cornhusker Rd Ste 207
Bellevue, NE 68005-7918
Phone
(402) 614-4300
NPI assigned
Jul 19, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT030476 PA
Physical Therapist 225100000X 4342 NE Primary

Addresses

Primary practice location

555 Cornhusker Rd Ste 207
Bellevue, NE 68005-7918

Mailing address

PO Box 34669
Omaha, NE 68134-0669
Phone (402) 932-6791

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230922002934 NE Practitioner - Physical Therapist in Private Practice 8820470172 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
University of Nebraska College of Medicine, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Makovicka Harms Group PCGroup PAC ID 0143374124, 48 clinicians

Practice addresses (Care Compare)

555 Cornhusker Rd
Suite 207
Bellevue, NE 68005-7918
Phone (402) 614-4300

Merit-based Incentive Payment System (MIPS)

Final score
32.9 of 100Reported as group
Quality
0
Improvement activities
40
Cost
59.68

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4342NEMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Drayer Physical Therapy Institute LLC CurrentSince Dec 5, 2022 Accepting new patients
Drayer Physical Therapy Institute LLC Physical Therapist Current Accepting new patients
Drayer Physical Therapy Institute LLC Physical Therapist CurrentSince Dec 5, 2022 Accepting new patients
Makovicka Harms Group PC Physical Therapist CurrentSince Sep 6, 2023 Accepting new patients
Makovicka Sylliaasen PC Physical Therapist PastSince Jan 6, 2010 Accepting new patients
Makovicka Harms Group, PC Physical Therapist Past Accepting new patients

Locations

1200 Corporate Dr
Ste 400
Hoover, AL 35242
Phone (423) 238-7568

555 Cornhusker Rd
Ste 207
Bellevue, NE 68005
Phone (402) 614-4300

15602 Whiting Cir
Ste 130
Bennington, NE 68007
Phone (402) 915-6773

20024 Glenmore Dr
Ste 101
Gretna, NE 68028
Phone (402) 332-3773

333 S 70th St
Ste 102
Lincoln, NE 68510
Phone (531) 500-4160

2436 N 48th St
Ste 101
Lincoln, NE 68504
Phone (402) 325-6341

7030 Helen Witt Dr
Ste A
Lincoln, NE 68512
Phone (402) 420-4545

7120 S 69th St
Ste 104
Lincoln, NE 68516
Phone (402) 413-0525

6909 S 157th St
Ste E
Omaha, NE 68136
Phone (402) 933-5448

6307 Center St
Ste 105
Omaha, NE 68106
Phone (402) 884-7453

4235 N 90th St
Omaha, NE 68134
Phone (402) 934-0045

3830 N 167th Ct
Ste 102
Omaha, NE 68116
Phone (402) 502-2290

1021 S 178th St
Ste 101
Omaha, NE 68118
Phone (402) 256-5856

11901 Pacific St
Ste 2
Omaha, NE 68154
Phone (402) 401-6151

8419 S 73rd Plz
Ste 104
Papillion, NE 68046
Phone (402) 991-2745

11476 S 72nd St
Ste 102
Papillion, NE 68046
Phone (402) 964-2045

16385 Westside Dr
Ste 1
Plattsmouth, NE 68048
Phone (402) 870-4521

559 W 15th St
Wahoo, NE 68066
Phone (402) 420-4545

13851 Guildford St
Waverly, NE 68462
Phone (402) 786-0476

3103 W Emaus Ave
Allentown, PA 18103
Phone (484) 387-1065

6299 Route 309
Ste 1F
New Tripoli, PA 18066
Phone (484) 387-1065

3722 Lehigh St
Ste 406
Whitehall, PA 18052
Phone (484) 387-1065

Organizations & group practices 6

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": "1658188800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694995200000",
    "number": "1679208268",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 34669",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681340669",
            "telephone_number": "402-932-6791"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "555 CORNHUSKER RD STE 207",
            "city": "BELLEVUE",
            "state": "NE",
            "postal_code": "680057918",
            "telephone_number": "402-614-4300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEWIS",
        "first_name": "KEATON",
        "middle_name": "M",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-07-19",
        "last_updated": "2023-09-18",
        "certification_date": "2023-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "PA",
            "license": "PT030476",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NE",
            "license": "4342",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bellevue, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.