Individual provider Active NPI

Jacqueline Belinda Lewis, MD

  • Surgery Physician
  • Birmingham, AL
National Provider Identifier
1770686198
Registry record updated Jun 18, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
11827 Issued in AL
Practice address
801 Princeton Ave SW
Professional Office BLDG I Ste 108
Birmingham, AL 35211
Phone
(205) 780-6090
Fax
(205) 780-3060
NPI assigned
Sep 7, 2006
Last updated
Jun 18, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 11827 AL Primary

Addresses

Primary practice location

801 Princeton Ave SW
Professional Office BLDG I Ste 108
Birmingham, AL 35211

Mailing address

801 Princeton Ave SW
Professional Office BLDG I Ste 108
Birmingham, AL 35211
Phone (205) 780-6090

Other identifiers 1

IdentifierTypeStateIssuer
000089750MedicaidAL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
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
I20120315000621 AL Practitioner - General Surgery 2062671720 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
University of Alabama School of Medicine, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

801 Princeton Swave
Suite 108
Birmingham, AL 35211-1306
Phone (205) 780-6090

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Hernia repair - groin (open)1-10
Mastectomy1-10
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
11827ALMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Jacqueline B. Lewis, MD, PC Surgery CurrentSince Nov 16, 1994 Accepting new patients

Locations

801 Princeton Ave SW
Ste 108
Birmingham, AL 35211
Phone (205) 780-6090

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.

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": "1157587200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1339977600000",
    "number": "1770686198",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 PRINCETON AVE SW",
            "address_2": "PROFESSIONAL OFFICE BLDG I STE 108",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "35211",
            "telephone_number": "205-780-6090",
            "fax_number": "205-780-3060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 PRINCETON AVE SW",
            "address_2": "PROFESSIONAL OFFICE BLDG I STE 108",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "35211",
            "telephone_number": "205-780-6090",
            "fax_number": "205-780-3060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEWIS",
        "first_name": "JACQUELINE",
        "middle_name": "BELINDA",
        "name_prefix": "Mrs.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-07",
        "last_updated": "2012-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "AL",
            "license": "11827",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000089750",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Birmingham, AL

Sources for this page

Verify at the official NPI Registry.