Organization Active NPI

Coastal Shoulder Surgery & Sports Medicine

  • Orthopaedic Surgery Physician
  • Largo, FL
National Provider Identifier
1922876796
Registry record updated Oct 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
Legal business name
COASTAL SHOULDER SURGERY & SPORTS MEDICINE
Practice address
8240 118TH Ave Ste 350
Largo, FL 33773-5015
Phone
(706) 596-8844
NPI assigned
Dec 12, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 15, 2025

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

Authorized official

Name
Dr. Robert Gordon LewisNPI 1255369120
Title
Owner
Phone
(727) 475-1166

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207X00000X Primary

Addresses

Primary practice location

8240 118TH Ave Ste 350
Largo, FL 33773-5015

Mailing address

8240 118TH Ave Ste 350
Largo, FL 33773-5015
Phone (727) 475-1166

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20240103003914 FL Part B Supplier - Clinic/Group Practice 5193176196 Receives reassigned benefits from 1 practitioner
Practice locations: Largo, FL
O20250130002907 FL DME Supplier - Physician - Orthopedic/Orthopedic Surgery 5193176196 Practice locations: Largo, FL

National Provider Directory

National Provider Directory

Locations

8240 118th Ave
Ste 350
Largo, FL 33773
Phone (706) 596-8844

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1702339200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1760486400000",
    "number": "1922876796",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8240 118TH AVE STE 350",
            "city": "LARGO",
            "state": "FL",
            "postal_code": "337735015",
            "telephone_number": "727-475-1166",
            "fax_number": "727-333-7776"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8240 118TH AVE STE 350",
            "city": "LARGO",
            "state": "FL",
            "postal_code": "337735015",
            "telephone_number": "706-596-8844"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COASTAL SHOULDER SURGERY & SPORTS MEDICINE",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-12-12",
        "last_updated": "2025-10-15",
        "certification_date": "2025-10-15",
        "status": "A",
        "authorized_official_last_name": "LEWIS",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "GORDON",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "727-475-1166",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Largo, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.