Individual provider Active NPI

Susan Jaana Lewis, M.D.

  • Emergency Medicine Physician
  • San Diego, CA
National Provider Identifier
1881622702
Registry record updated Jun 27, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
G84444 Issued in CA
Practice address
4077 Fifth Ave
San Diego, CA 92103-2105
Phone
(619) 260-7000
Fax
(619) 260-7050
NPI assigned
Jun 29, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 27, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X G84444 CA Primary

Addresses

Primary practice location

4077 Fifth Ave
San Diego, CA 92103-2105

Mailing address

PO Box 662110
Arcadia, CA 91066-2110
Phone (626) 447-0296

Other identifiers 1

IdentifierTypeStateIssuer
00G844440MedicaidCA

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041209000859 CA Practitioner - Emergency Medicine 1254397300 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
University of California, San Diego School of Medicine, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pacific Emergency Providers a Prof CorpGroup PAC ID 1557327608, 24 clinicians

Practice addresses (Care Compare)

4077 5TH Ave
San Diego, CA 92103-2105
Phone (619) 686-3800

Hospital & facility affiliations

  • Scripps Mercy Hospital Hospital, San Diego, CA, CCN 050077

Merit-based Incentive Payment System (MIPS)

Final score
93.4 of 100Reported as group
Quality
82.48
Improvement activities
40
Cost
76.78

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G84444CAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Scripps Health Current Accepting new patients
Pacific Emergency Providers, a Prof. Corp. Emergency Medicine CurrentSince Jan 1, 2005 Accepting new patients

Locations

4077 5th Ave
#M
San Diego, CA 92103
Phone (619) 260-7000

4077 5th Ave
San Diego, CA 92103
Phone (619) 260-7245

Interoperability endpoints

  • Direct secure messaging: slewis27217@scrippshlth.medalliesdirect.net

Organizations & group practices 2

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.

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": "1151539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1214524800000",
    "number": "1881622702",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 662110",
            "city": "ARCADIA",
            "state": "CA",
            "postal_code": "910662110",
            "telephone_number": "626-447-0296",
            "fax_number": "626-447-6057"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4077 FIFTH AVE",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921032105",
            "telephone_number": "619-260-7000",
            "fax_number": "619-260-7050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEWIS",
        "first_name": "SUSAN",
        "middle_name": "JAANA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-06-29",
        "last_updated": "2008-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "G84444",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G844440",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.