Active NPI
Michael Lewis
- Psychologist
- New Brunswick, NJ
National Provider Identifier
1811058001
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 35SI002116
- Practice address
- 97 Paterson St
Robert Wood Johnson Professional Center
New Brunswick, NJ 08901-2160 - Phone
- (732) 235-7888
- NPI assigned
- Dec 12, 2006
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Psychologist | 103T00000X | 35SI002116 | NJ | Primary |
Addresses
Primary practice location
97 Paterson St
Robert Wood Johnson Professional Center
New Brunswick, NJ 08901-2160
Mailing address
66 West Gilbert St
Red Bank, NJ 07701
Phone (732) 212-0051
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0361305 | Medicaid | NJ |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine, Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 35SI002116 | NJ | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1165881600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1205107200000",
"number": "1811058001",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "66 WEST GILBERT ST",
"city": "RED BANK",
"state": "NJ",
"postal_code": "07701",
"telephone_number": "732-212-0051",
"fax_number": "732-212-0713"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "97 PATERSON ST",
"address_2": "ROBERT WOOD JOHNSON PROFESSIONAL CENTER",
"city": "NEW BRUNSWICK",
"state": "NJ",
"postal_code": "089012160",
"telephone_number": "732-235-7888"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEWIS",
"first_name": "MICHAEL",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-12-12",
"last_updated": "2008-03-10",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "NJ",
"license": "35SI002116",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0361305",
"state": "NJ"
}
],
"endpoints": [],
"other_names": []
}Other providers in New Brunswick, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.