Active NPI
Kyle Lewis, M.D.
- Emergency Medicine Physician
- State College, PA
National Provider Identifier
1871911610
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Emergency Medicine Physician
- License
- MD460713
- Practice address
- 1800 East Park Ave
State College, PA 16803-1501 - Phone
- (814) 231-7000
- NPI assigned
- Mar 30, 2014
- 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 |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | MD460713 | PA | Primary |
Addresses
Primary practice location
1800 East Park Ave
State College, PA 16803-1501
Mailing address
1800 East Park Avenue Attn Cema
State College, PA 16803
Phone (814) 231-7000
Other practice location 1
6411 Fannin St
Houston, TX 77030-1501
Phone (713) 704-4060
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in PA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD460713 | PA | MD | Emergency Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Centre Emergency Medical Associates, PC. | Emergency Medicine | Current | Accepting new patients |
Locations
155 Wellness Way
State College, PA 16803
Phone (800) 367-0179
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 and National Provider Directory roles.
-
- Emergency Medicine Physician
- State College, PA
- NPI 1609891365
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1396137600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1521244800000",
"number": "1871911610",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1800 EAST PARK AVENUE ATTN CEMA",
"city": "STATE COLLEGE",
"state": "PA",
"postal_code": "16803",
"telephone_number": "814-231-7000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1800 EAST PARK AVE",
"city": "STATE COLLEGE",
"state": "PA",
"postal_code": "168031501",
"telephone_number": "814-231-7000"
}
],
"practiceLocations": [
{
"address_1": "6411 Fannin St",
"address_purpose": "LOCATION",
"city": "Houston",
"state": "TX",
"postal_code": "770301501",
"country_code": "US",
"telephone_number": "713-704-4060",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "LEWIS",
"first_name": "KYLE",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2014-03-30",
"last_updated": "2018-03-17",
"status": "A"
},
"taxonomies": [
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "PA",
"license": "MD460713",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in State College, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.