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BENJAMIN LEW DO
NPI 1578205373
Student in an Organized Health Care Education/Training Program in Fontana, CA

Active since April 12, 2022PECOS Enrolled
17234 VALLEY BLVD, BUILDING A, FONTANA, CA 92335(909) 427-4128(909) 427-6288 Get Directions Write a Review

NPPES record last updated: July 27, 2022. Verified against the NPPES registry weekly; last sync: November 08, 2026.

Record update history: Jul 27, 2022, Apr 12, 2022 (2 updates tracked since 2022).

About Benjamin Lew Do NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

BENJAMIN LEW DO (NPI 1578205373) is an individual student in an organized health care education/training program in Fontana, California and active in the NPI registry since April 2022. He is enrolled in Medicare PECOS and is a graduate of Other (2022).

NPPES Registry Identity

NPI1578205373
Entity TypeIndividualMale
Primary Taxonomy390200000X
Provider Legal NameBENJAMIN LEWCredential: DO
Location Address17234 VALLEY BLVD, BUILDING AFontana, CA 92335-6720
Mailing Address17234 Valley Blvd, Building AFontana, CA 92335-6720 · (909) 427-4128 · Fax (909) 427-6288
Phone(909) 427-4128
Fax(909) 427-6288
Sole ProprietorNo
Medical School CMSOtherGraduated 2022
Enumeration DateApril 12, 2022
Last NPPES UpdateJuly 27, 20222 updates tracked since enumeration
NPPES CertifiedMarch 26, 2022
✔ NPI 1578205373 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
17234 VALLEY BLVD, Fontana, CA 92335
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Benjamin Lew Do is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID6406203850
PECOS Enrollment IDI20260701001966
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Benjamin Lew reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Southern California Permanente Medical Group
0.2 mi
Health Maintenance Organization
9961 SIERRA AVE
Fontana, CA 92335
  • Reassigned Medicare billing, California enrollment
  • 5,228 clinicians in this Medicare group
NPI 1689606196 (909) 427-3910

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

VENKATA SAITEJA PAMIDIMUKKALA DO
Student in an Organized Health Care Education/Training Program
17234 VALLEY BLVD
FONTANA, CA 92335
San Bernardino County (925) 819-4476
JAMI WANG DO
Psychiatry & Neurology (Psychiatry)
17234 VALLEY BLVD, BUILDING A
FONTANA, CA 92335
San Bernardino County (909) 427-5679
URVASHI SINGH
Student in an Organized Health Care Education/Training Program
17234 VALLEY BLVD, BUILDING A
FONTANA, CA 92335
San Bernardino County (909) 427-5679
GENISE URSIE JADE BROWNE MD
Family Medicine
17234 VALLEY BLVD, BUILDING A
FONTANA, CA 92335
San Bernardino County (407) 309-0538
DR. ALEXANDER JASON BRESSLER DO
Family Medicine
17234 VALLEY BLVD
FONTANA, CA 92335
San Bernardino County (909) 427-5084
DR. GREISHKA NICOLE CORDERO BAEZ MD
Student in an Organized Health Care Education/Training Program
17234 VALLEY BLVD, BUILDING A
FONTANA, CA 92335
San Bernardino County (909) 427-5679
DR. JING YA GAO DO
Student in an Organized Health Care Education/Training Program
17234 VALLEY BLVD
FONTANA, CA 92335
San Bernardino County (833) 574-2273
EMILY ISABEL MULDER
Student in an Organized Health Care Education/Training Program
17234 VALLEY BLVD, BUILDING A
FONTANA, CA 92335
San Bernardino County (833) 574-2273

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Benjamin Lew's NPI number?

The NPI number for Benjamin Lew is 1578205373. It was assigned to this individual provider in the NPPES registry on April 12, 2022.

Where is Benjamin Lew located?

Benjamin Lew practices at 17234 Valley Blvd Building A, Fontana, CA 92335. The listed phone number is (909) 427-4128.

What is Benjamin Lew's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Is Benjamin Lew enrolled in Medicare?

Yes. Benjamin Lew is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Benjamin Lew's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Benjamin Lew reassigns Medicare benefits to Southern California Permanente Medical Group (Fontana, CA). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Benjamin Lew's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Benjamin Lew was last updated on July 27, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.