KATHLEEN LEWIS
NPI 1053963611
Nurse Practitioner in Shelby Township, MI
About Kathleen Lewis NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
KATHLEEN LEWIS (NPI 1053963611) is an individual nurse practitioner in Shelby Township, Michigan, licensed in Michigan (4704313036) and active in the NPI registry since July 2019. She is enrolled in Medicare PECOS, is affiliated with Beaumont Hospital Royal Oak, and maintains a secondary practice location in Rochester Hills.
NPPES Registry Identity
Specialties & Licenses
Secondary Practice Location 1
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Kathleen Lewis is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.
Medicare Billing Reassignments
2Medicare enrollment records show Kathleen Lewis reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Berkley, MI 48072
- Reassigned Medicare billing, Michigan enrollment
- 11 clinicians in this Medicare group
Redford, MI 48239
- Reassigned Medicare billing, Michigan enrollment
- 10 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Hospital Affiliations CMS Care Compare
Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.
Beaumont Hospital Royal Oak
Acute Care Hospitals · Royal Oak, MIPhysician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 48317 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Other Providers at the Same Location NPPES 3
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
SHELBY CHARTER TOWNSHIP, MI 48317
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 Kathleen Lewis's NPI number?
The NPI number for Kathleen Lewis is 1053963611. It was assigned to this individual provider in the NPPES registry on July 14, 2019.
Where is Kathleen Lewis located?
Kathleen Lewis practices at 46961 Van Dyke Ave, Shelby Township, MI 48317. The listed phone number is (586) 991-5205.
What is Kathleen Lewis's specialty?
The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.
Is Kathleen Lewis enrolled in Medicare?
Yes. Kathleen Lewis is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.
Which organizations bill Medicare for Kathleen Lewis's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Kathleen Lewis reassigns Medicare benefits to 2 organizations: Berkley Urgent Care PLLC (Berkley, MI) and Express Health Urgent Care PLLC (Redford, MI). Each 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 Kathleen Lewis's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
Is Kathleen Lewis affiliated with any hospitals?
According to CMS data, Kathleen Lewis is affiliated with Beaumont Hospital Royal Oak.
When was this NPI record last updated?
The NPPES record for Kathleen Lewis was last updated on July 18, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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.
# Kathleen Lewis · NPI 1053963611
Nurse Practitioner physician in Shelby Township, Michigan. Individual provider, active in the CMS NPPES registry since July 14, 2019.
## Identity
- **NPI:** 1053963611 (Entity type: Individual)
- **Enumerated:** July 14, 2019
- **Primary specialty:** Nurse Practitioner · taxonomy 363L00000X
- **State license:** 4704313036 (Michigan)
- **Sole proprietor:** No
## Practice location
- **Address:** 46961 VAN DYKE AVE, Shelby Township, MI 48317
- **Phone:** (586) 991-5205
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** 2 organizations under Medicare reassignment (form CMS-855R): Berkley Urgent Care PLLC (NPI 1083022735, Berkley, MI); Express Health Urgent Care PLLC (NPI 1265157697, Redford, MI) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2019
## Record status
- **NPPES last updated:** July 18, 2019
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Source: [NPI Profile](https://npiprofile.com/npi/1053963611) · Data from the CMS NPPES public registry.