NPIMap

Individual provider Active NPI

Kourtny Deana Lewis, PA-C

  • Physician Assistant
  • District Heights, MD
National Provider Identifier
1104662386
Registry record updated Oct 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
C0010076 Issued in MD
Practice address
5710 Silver Hill Rd
District Heights, MD 20747-1101
Phone
(301) 736-7000
NPI assigned
Jul 8, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 14, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X C0010076 MD Primary

Addresses

Primary practice location

5710 Silver Hill Rd
District Heights, MD 20747-1101

Mailing address

7903 Prentice CT
Fort Washington, MD 20744-4449
Phone (240) 605-3833

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251202000791 DC Practitioner - Physician Assistant 4880187558 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Luminis Health Medical Group, LLCGroup PAC ID 2860447315, 540 clinicians

Practice addresses (Care Compare)

4175 N Hanson Court
201 Luminis Health Breast Center of Bowie
Bowie, MD 20716-3181
Phone (443) 481-5300

4175 N Hanson CT
Bowie, MD 20716-3181

5710 Silver Hill Rd
Suite 210
District Heights, MD 20747-1101
Phone (301) 736-7000

Hospital & facility affiliations

  • Luminis Health Anne Arundel Medical Center, Inc Hospital, Annapolis, MD, CCN 210023

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
C0010076MDMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Luminis Health Medical Group, LLC Current Accepting new patients
Luminis Health Medical Group, LLC CurrentSince Oct 1, 2025 Accepting new patients
Luminis Health Medical Group, LLC CurrentSince Oct 1, 2025 Accepting new patients
Luminis Health Medical Group, LLC Past Accepting new patients

Locations

4175 N Hanson Ct
Ste 201
Bowie, MD 20716
Phone (443) 481-1199

5859 Allentown Way
Temple Hills, MD 20748
Phone (240) 563-1026

Interoperability endpoints

  • Direct secure messaging: klewis186925@direct.aahs.org

Organizations & group practices 13

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

View all 13

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1720396800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760400000000",
    "number": "1104662386",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7903 PRENTICE CT",
            "city": "FORT WASHINGTON",
            "state": "MD",
            "postal_code": "207444449",
            "telephone_number": "240-605-3833"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5710 SILVER HILL RD",
            "city": "DISTRICT HEIGHTS",
            "state": "MD",
            "postal_code": "207471101",
            "telephone_number": "301-736-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEWIS",
        "first_name": "KOURTNY",
        "middle_name": "DEANA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-07-08",
        "last_updated": "2025-10-14",
        "certification_date": "2025-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MD",
            "license": "C0010076",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in District Heights, MD

Sources for this page

Verify at the official NPI Registry.