Individual provider Active NPI

Roger William Lewis, MD

  • Obstetrics & Gynecology Physician
  • Turlock, CA
National Provider Identifier
1699876086
Registry record updated Oct 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
G65192 Issued in CA
Practice address
1729 N Olive Ave
3
Turlock, CA 95382-2501
Phone
(209) 634-9034
Fax
(209) 634-0794
NPI assigned
Sep 26, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 19, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X G65192 CA Primary

Addresses

Primary practice location

1729 N Olive Ave
3
Turlock, CA 95382-2501

Mailing address

1729 N Olive Ave
3
Turlock, CA 95382-2501
Phone (209) 634-9034

Other identifiers 2

IdentifierTypeStateIssuer
1699876086MedicaidCA
GR0043050MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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 1

Enrollment IDStateProvider typePAC IDDetails
I20051031000396 CA Practitioner - Obstetrics/Gynecology 1850318767 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
University of Utah School of Medicine, 1981
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
OB GYN Associates of Turlock a Medical Group IncGroup PAC ID 5597701243, 2 clinicians

Practice addresses (Care Compare)

1729 N Olive Ave
Suite 3
Turlock, CA 95382-2501
Phone (209) 634-9034

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G65192CAMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Obhg California, P.C. Obstetrics & Gynecology CurrentSince Nov 10, 2020 Accepting new patients
OB GYN Associates of Turlock a Medical Group Inc Obstetrics & Gynecology CurrentSince Oct 31, 1988 Accepting new patients
Emanuel Medical Center, Inc. Past Accepting new patients

Locations

333 Mercy Ave
Merced, CA 95340
Phone (209) 385-1280

23625 Wr Holman Hwy
Monterey, CA 93940
Phone (831) 622-2708

825 Delbon Ave
Turlock, CA 95382
Phone (209) 664-2744

1729 N Olive Ave
Ste 3
Turlock, CA 95382
Phone (209) 634-9034

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

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": "1159228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666137600000",
    "number": "1699876086",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1729 N OLIVE AVE",
            "address_2": "3",
            "city": "TURLOCK",
            "state": "CA",
            "postal_code": "953822501",
            "telephone_number": "209-634-9034",
            "fax_number": "209-634-0794"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1729 N OLIVE AVE",
            "address_2": "3",
            "city": "TURLOCK",
            "state": "CA",
            "postal_code": "953822501",
            "telephone_number": "209-634-9034",
            "fax_number": "209-634-0794"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEWIS",
        "first_name": "ROGER",
        "middle_name": "WILLIAM",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-26",
        "last_updated": "2022-10-19",
        "certification_date": "2022-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "CA",
            "license": "G65192",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1699876086",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0043050",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Turlock, CA

Sources for this page

Verify at the official NPI Registry.