Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Tracey Lee Lewis, PA-C

Individual provider Physician Assistant · NPI 1528439346

Tracey Lee Lewis, PA-C is a Physician Assistant in Decatur, Illinois. Qualified in 2015, 11 years ago. Practices with Board of Trustees of Southern Illinois University, a 142-clinician group and accepts Medicare assignment. Licensed in Illinois.

Years since qualifying
11
Licensed in
IL
In the registry since
2015
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

102 W Kenwood Ave Ste 100
Decatur, IL 62526
Phone: (217) 872-3800
Fax: (217) 872-0849
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 085005631 (IL)

Record details

NPI number1528439346
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorNo
NPI enumeratedOctober 20, 2015
Last updated in NPPESOctober 22, 2020
Certification dateOctober 22, 2020

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2015 (11 years in practice)
Group practice Board Of Trustees Of Southern Illinois University — 142 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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