Active NPI
Mark Benton Lewis
- Surgery Physician
- Los Angeles, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- A188704
- Practice address
- 1200 N State St
Clinic Tower, Suite A7D
Los Angeles, CA 90033-1029 - Phone
- (323) 442-7824
- Fax
- (323) 442-8009
- NPI assigned
- Apr 14, 2021
- Last updated
- Jan 15, 2025
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician | 208600000X | A188704 | CA | Primary |
Addresses
Primary practice location
1200 N State St
Clinic Tower, Suite A7D
Los Angeles, CA 90033-1029
Mailing address
1200 N State St
Clinic Tower, Suite A7D
Los Angeles, CA 90033-1029
Phone (323) 442-7824
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- General Surgery
- Education
- University of Mississippi School of Medicine, 2022
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
28212 Kelly Johnson Pkwy
Suite 200
Valencia, CA 91355-5090
Phone (213) 228-3538
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Removal of tissue | 27 |
| Removal of skin lesions | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A188704 | CA | MD | Surgery Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Izuchukwu Okpara MD Inc | Surgery | Current | Accepting new patients |
Locations
5430 Arlington Ave
Riverside, CA 92504
Phone (714) 458-4617
25044 Peachland Ave
Ste 110
Santa Clarita, CA 91321
28212 Kelly Johnson Pkwy
Ste 200
Valencia, CA 91355
Phone (661) 388-5945
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1618358400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1736899200000",
"number": "1740861590",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1200 N STATE ST",
"address_2": "CLINIC TOWER, SUITE A7D",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900331029",
"telephone_number": "323-442-7824",
"fax_number": "323-442-8009"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1200 N STATE ST",
"address_2": "CLINIC TOWER, SUITE A7D",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900331029",
"telephone_number": "323-442-7824",
"fax_number": "323-442-8009"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEWIS",
"first_name": "MARK",
"middle_name": "BENTON",
"name_prefix": "Mr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-04-14",
"last_updated": "2025-01-15",
"certification_date": "2025-01-15",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "CA",
"license": "A188704",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Los Angeles, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- 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.