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KATHLEEN LEWIS
NPI 1053963611
Nurse Practitioner in Shelby Township, MI

Active since July 14, 2019PECOS Enrolled
46961 VAN DYKE AVE, SHELBY TOWNSHIP, MI 48317(586) 991-5205 Get Directions Write a Review

NPPES record last updated: July 18, 2019. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jul 18, 2019, Jul 14, 2019 (2 updates tracked since 2019).

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 and maintains a secondary practice location in Rochester Hills.

NPPES Registry Identity

NPI1053963611
Entity TypeIndividualFemale
Primary Taxonomy363L00000X
Provider Legal NameKATHLEEN LEWIS
Location Address46961 VAN DYKE AVEShelby Township, MI 48317
Mailing Address517 Hawthorn AveRoyal Oak, MI 48067-3619 · (248) 376-0908
Phone(586) 991-5205
Sole ProprietorNo
Enumeration DateJuly 14, 2019
Last NPPES UpdateJuly 18, 20192 updates tracked since enumeration
✔ NPI 1053963611 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363L00000X
License✔ Licensed in MI · 4704313036
Definition
(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.
46961 VAN DYKE AVE, Shelby Township, MI 48317
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Secondary Practice Location 1

Location 12915 Walton BlvdRochester Hills, MI 48309-1419 · Phone (248) 759-4222

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Kathleen Lewis is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

Physician 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.

New Patient
$90.76 typical visit price
range $58.04 – $177.36
Typical copayment $22.69 (range $14.51 – $44.34)
Most-billed visit code 99203
Established Patient
$102.35 typical visit price
range $18.32 – $143.49
Typical copayment $25.58 (range $4.58 – $35.87)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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.

JONATHON ALLAN SHORT PA-C
Physician Assistant (Medical)
46961 VAN DYKE AVE
SHELBY CHARTER TOWNSHIP, MI 48317
Macomb County (586) 991-5205
MRS. DANIELLE NICOLE OCAMPO PA-C
Physician Assistant
46961 VAN DYKE AVE
SHELBY TWP, MI 48317
Macomb County (586) 991-5205
ANNE KATOULA FNP-BC
Nurse Practitioner (Family)
46961 VAN DYKE AVE
SHELBY TOWNSHIP, MI 48317
Macomb County (586) 991-5205

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 enrollment system.

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.