Individual provider Active NPI

Gary William Lewis, MD

  • Cardiovascular Disease Physician
  • Indiana, PA
National Provider Identifier
1871574202
Registry record updated Apr 13, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
MD040211L Issued in PA
Practice address
1265 Wayne Ave Ste 306
Indiana, PA 15701-3501
Phone
(724) 463-9701
Fax
(724) 463-9702
NPI assigned
Nov 11, 2005
Last updated
Apr 13, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 13, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD040211L PA
Cardiovascular Disease Physician 207RC0000X D0059982 MD
Cardiovascular Disease Physician 207RC0000X MD040211L PA Primary

Addresses

Primary practice location

1265 Wayne Ave Ste 306
Indiana, PA 15701-3501

Mailing address

640 Kolter Dr
Indiana, PA 15701-3570
Phone (724) 357-7196

Other practice location 1

1842 Meridian Dr
Hagerstown, MD 21742-1232
Phone (717) 377-8355

Other identifiers 13

IdentifierTypeStateIssuer
110868OtherMDJOHNS HOPKINS HEALTHCARE
B3890008OtherDCBC/BS
63366502OtherMHBC/BS
145744300OtherUS DEPT OF LABOR
5127062OtherMDAETNA PPO
3536055OtherMDAETNA HMO
867633OtherPAMEDICARE GROUP #
402544000MedicaidMD
1759448OtherMDUNITED HEALTHCARE
3979804OtherMDCIGNA
1007307260040OtherPAMEDICAID GROUP #
2007547000MedicaidWV
5121416OtherMDMAMSI

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address gary.lewis@irmc.cernerdirect.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20061121000672 PA Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal Medicine 5597743484 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)Also: Internal Medicine
Education
Other, 1985
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

640 Kolter Dr
Indiana, PA 15701-3570

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
93.9 of 100Reported as apm
Quality
85.02
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Fayette Physician Network Inc CurrentSince Nov 1, 2019 Accepting new patients
Indiana Healthcare Physician Services Inc Internal Medicine CurrentSince Jan 1, 2020 Accepting new patients
Indiana Healthcare Physician Services, Inc CurrentSince Jan 1, 2020 Accepting new patients
Fayette Physician Network Inc Internal Medicine CurrentSince Nov 1, 2019 Accepting new patients
Windber Hospital, Inc. Past Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

1265 Wayne Ave
Ste 107
Indiana, PA 15701
Phone (724) 349-7980

1265 Wayne Ave
Ste 305
Indiana, PA 15701
Phone (724) 349-3110

1265 Wayne Ave
Ste 306
Indiana, PA 15701
Phone (724) 349-3233

640 Kolter Dr
Indiana, PA 15701
Phone (724) 357-7196

835 Hospital Rd
Indiana, PA 15701
Phone (724) 357-7000

879 Hospital Rd
Indiana, PA 15701
Phone (724) 349-3031

81 Hillcrest Dr
Punxsutawney, PA 15767
Phone (814) 938-1800

201 Mary Higginson Ln
Uniontown, PA 15401
Phone (724) 430-5940

500 W Berkeley St
Uniontown, PA 15401
Phone (724) 430-5000

Interoperability endpoints

  • Direct secure messaging: gary.lewis@irmc.cernerdirect.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 5

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": "1131667200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618272000000",
    "number": "1871574202",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "640 KOLTER DR",
            "city": "INDIANA",
            "state": "PA",
            "postal_code": "157013570",
            "telephone_number": "724-357-7196",
            "fax_number": "724-357-7279"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1265 WAYNE AVE STE 306",
            "city": "INDIANA",
            "state": "PA",
            "postal_code": "157013501",
            "telephone_number": "724-463-9701",
            "fax_number": "724-463-9702"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1842 Meridian Dr",
            "address_purpose": "LOCATION",
            "city": "Hagerstown",
            "state": "MD",
            "postal_code": "217421232",
            "country_code": "US",
            "telephone_number": "717-377-8355",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEWIS",
        "first_name": "GARY",
        "middle_name": "WILLIAM",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-11",
        "last_updated": "2021-04-13",
        "certification_date": "2021-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MD040211L",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "MD",
            "license": "D0059982",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "PA",
            "license": "MD040211L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "JOHNS HOPKINS HEALTHCARE",
            "identifier": "110868",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS",
            "identifier": "B3890008",
            "state": "DC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS",
            "identifier": "63366502",
            "state": "MH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "US DEPT OF LABOR",
            "identifier": "145744300",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA PPO",
            "identifier": "5127062",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA HMO",
            "identifier": "3536055",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP #",
            "identifier": "867633",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "402544000",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "1759448",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "3979804",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID GROUP #",
            "identifier": "1007307260040",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2007547000",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAMSI",
            "identifier": "5121416",
            "state": "MD"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "gary.lewis@irmc.cernerdirect.com",
            "affiliation": "N",
            "endpointDescription": "Cerner Millennium Direct Messaging Address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Direct Messaging",
            "address_1": "1265 Wayne Ave Ste 306",
            "city": "Indiana",
            "state": "PA",
            "country_code": "US",
            "postal_code": "157013501",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Indiana, PA

Sources for this page

Verify at the official NPI Registry.