CMS-1500 Box 24J / 33a • NPI
1023177490
Type 2 Organization (Box 32a/33a)
HIPAA NUCC Taxonomy • CMS Code
3336C0003X (CMS 58)
Licensed & Credentialed Suppliers — Pharmacy, Community — Retail Pharmacy
Box 32 Service Location & ZIP+4
20 N SALEM RD, CROSS RIVER, NY, 10518-1104
✓ 9-Digit EDI 837 ZIP+4 (10518-1104)
✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR:
NPI
1023177490 (LEWISBORO PHARMACY INC) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).
CMS Medicare Order & Referring PECOS Eligibility
Empirical CMS Medicare Claims, CPT Utilization & Part D Prescribing (NPI #1023177490)
Medicare Beneficiaries
102
Total Billed Services
318
Distinct CPT/HCPCS Codes
4
Medicare Allowed Total
$25,328.36
Actual Top Billed CPT / HCPCS Procedures (CMS Part B)
| CPT / HCPCS | Clinical Procedure Description | Services |
|---|---|---|
90480 | Admn sarscov2 vacc 1 dose | 75 |
90662 | Influenza vaccine split virus, preservative free | 84 |
91322 | Sarscov2 vac 50 mcg/0.5ml im | 75 |
G0008 | Administration of influenza virus vaccine | 84 |
Official CMS NPPES Credential & Practice Profile
| 10-Digit NPI Number | 1023177490 (NPI-2 Organization / Facility) |
|---|---|
| Provider / Legal Name | LEWISBORO PHARMACY INC |
| Plain-English Specialty | Licensed & Credentialed Suppliers — Pharmacy, Community — Retail Pharmacy NUCC Code: 3336C0003X (Pharmacy, Community/Retail Pharmacy) |
| Certifying / Licensing Body | State Medical / Healthcare Licensing Board & National Specialty Board |
| Practice Location Address | 20 N SALEM RD, CROSS RIVER, NY, 10518-1104 |
| Practice Telephone / Fax | Tel: (914) 763-3152 | Fax: (914) 763-6567 |
| Administrative Mailing Address | PO BOX 696, CROSS RIVER, NY, 10518-0696 |
| Enumeration & Last Sync | Enumerated: 2006-12-08 | CMS Record Updated: 2016-11-21 |
| Authorized Official | STUART FELDMAN (VP PIC OWNER) |
Clinic Location, Accessibility & Directions
📍 Practice Location & Patient Access
🗺️ Open in Google Maps 🏥 More Providers in CROSS RIVER
🔒 Are you LEWISBORO PHARMACY INC? Get your Verified NPI Clinic Badge or request personal phone/address redaction →
Plain-English Taxonomy & CMS Crosswalk (3336C0003X)
What Does Taxonomy Code 3336C0003X Mean?
In the HIPAA National Uniform Claim Committee (NUCC) classification, code 3336C0003X translates to:
"Licensed & Credentialed Suppliers — Pharmacy, Community — Retail Pharmacy"
Specialty Clinical Procedures & Therapeutic Classes
Standard Scope of Care (LEWISBORO PHARMACY INC)
Typical CPT / Diagnostic Procedures:- Comprehensive Outpatient & Inpatient Clinical Evaluation (CPT 99202–99215)
- Diagnostic Workup, Laboratory Ordering & Evidence-Based Care Coordination
- Preventive Screening, Patient Counseling & Multidisciplinary Referral
- Evidence-Based Specialty Pharmacotherapy & Preventive Regimens (CMS Part D Standard)
All Registered NUCC Taxonomies & State Licenses
| Taxonomy Code & Plain-English Description | State License & Primary Status |
|---|---|
333600000X — PharmacyPlain English: Licensed & Credentialed Suppliers — Pharmacy | State: N/A | License: Verified | Primary: Secondary |
3336C0003X — Pharmacy, Community/Retail PharmacyPlain English: Licensed & Credentialed Suppliers — Pharmacy, Community — Retail Pharmacy | State: NY | License: 014021 | Primary: Yes (Primary) |
Medical Billing, RCM & Hospital Credentialing Teams:
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