Individual provider Active NPI

Jacqueline Lewis, CNM

  • Obstetrics & Gynecology Physician
  • New York, NY
National Provider Identifier
1962483388
Registry record updated Sep 27, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
430433 Issued in NY
Practice address
10 Union SQ E
Bimc Dept of OB GYN
New York, NY 10003-3314
Phone
(212) 844-8592
NPI assigned
Nov 11, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 430433 NY Primary

Addresses

Primary practice location

10 Union SQ E
Bimc Dept of OB GYN
New York, NY 10003-3314

Mailing address

PO Box 95000-2428
Philadelphia, PA 19195-2428
Phone (212) 844-8592

Other identifiers 1

IdentifierTypeStateIssuer
01596794MedicaidNY

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040722000778 NY Practitioner - Certified Nurse Midwife (CNM) 1658351481 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Midwife

Practice roles

OrganizationSpecialtyStatusNew patients
Icahn School of Medicine at Mount Sinai CurrentSince Oct 1, 2014 Accepting new patients
Icahn School of Medicine at Mount Sinai Obstetrics & Gynecology CurrentSince Oct 1, 2014 Accepting new patients
Bimc OB-GYN Associates Obstetrics & Gynecology Past Accepting new patients
Bimc Faculty Practice Obstetrics & Gynecology Past Accepting new patients

Locations

10 Union Sq E
New York, NY 10003
Phone (212) 253-6800

10 Union Sq E
Ste 2B
New York, NY 10003
Phone (212) 420-2577

Organizations & group practices 4

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.

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": "1348704000000",
    "number": "1962483388",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 95000-2428",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191952428",
            "telephone_number": "212-844-8592"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 UNION SQ E",
            "address_2": "BIMC DEPT OF OB GYN",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100033314",
            "telephone_number": "212-844-8592"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEWIS",
        "first_name": "JACQUELINE",
        "credential": "CNM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-11",
        "last_updated": "2012-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NY",
            "license": "430433",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01596794",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.