Individual provider Active NPI

Lewis Clayman, D.M.D., M.D.

  • Oral and Maxillofacial Surgery (Dentist)
  • Pinole, CA
National Provider Identifier
1992799613
Registry record updated Apr 12, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
049855 Issued in MI
Practice address
2150 Appian Way
Ste 201
Pinole, CA 94564
Phone
(510) 724-3922
Fax
(510) 724-3922
NPI assigned
Sep 8, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 12, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist) 1223S0112X 049855 MI Primary

Addresses

Primary practice location

2150 Appian Way
Ste 201
Pinole, CA 94564

Mailing address

2150 Appian Way
Ste 201
Pinole, CA 94564
Phone (510) 724-3922

Other identifiers 1

IdentifierTypeStateIssuer
103322652MedicaidMI

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160106001417 CA Practitioner - Oral Surgery 8426078163

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
049855MIMDOral and Maxillofacial Surgery (Dentist)

NPI Registry JSON

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

{
    "created_epoch": "1126137600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1365724800000",
    "number": "1992799613",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2150 APPIAN WAY",
            "address_2": "STE 201",
            "city": "PINOLE",
            "state": "CA",
            "postal_code": "94564",
            "telephone_number": "510-724-3922",
            "fax_number": "510-724-1037"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2150 APPIAN WAY",
            "address_2": "STE 201",
            "city": "PINOLE",
            "state": "CA",
            "postal_code": "94564",
            "telephone_number": "510-724-3922",
            "fax_number": "510-724-3922"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLAYMAN",
        "first_name": "LEWIS",
        "name_prefix": "Mr.",
        "credential": "D.M.D., M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-08",
        "last_updated": "2013-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "MI",
            "license": "049855",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "103322652",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pinole, CA

Sources for this page

Verify at the official NPI Registry.