Individual provider Active NPI

Ellen Lewis, DC

  • Chiropractor
  • Larchmont, NY
National Provider Identifier
1891873857
Registry record updated May 20, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
X005495-1 Issued in NY
Practice address
178 Myrtle Boulevard
Larchmont, NY 10538
Phone
(914) 834-0058
Fax
(914) 834-4015
NPI assigned
Nov 1, 2006
Last updated
May 20, 2014By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 20, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X X005495 NY
Chiropractor 111N00000X X005495-1 NY Primary

Addresses

Primary practice location

178 Myrtle Boulevard
Larchmont, NY 10538

Mailing address

178 Myrtle Boulevard
Larchmont, NY 10538
Phone (914) 834-0058

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20141104000904 NY Practitioner - Chiropractic 5294737276 Practice locations: Larchmont, NY

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
New York Chiropractic College, 1988
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

178 Myrtle Blvd
Suite 103
Larchmont, NY 10538-2048
Phone (914) 834-0058

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
X005495NYMDChiropractor
X005495-1NYMDChiropractor

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1400544000000",
    "number": "1891873857",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "178 MYRTLE BOULEVARD",
            "city": "LARCHMONT",
            "state": "NY",
            "postal_code": "10538",
            "telephone_number": "914-834-0058",
            "fax_number": "914-834-4015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "178 MYRTLE BOULEVARD",
            "city": "LARCHMONT",
            "state": "NY",
            "postal_code": "10538",
            "telephone_number": "914-834-0058",
            "fax_number": "914-834-4015"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEWIS",
        "first_name": "ELLEN",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-01",
        "last_updated": "2014-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NY",
            "license": "X005495",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NY",
            "license": "X005495-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Larchmont, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.