Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Kevan G Lewis, MD

Individual provider Dermatology Physician · NPI 1497970560

Kevan G Lewis, MD is a Micrographic Dermatologic Surgery (Mds) in Green Bay, Wisconsin. Graduated from University of California, Geffen School of Medicine in 2004, 22 years ago. Practices with New Dermatology Group Ltd, a 23-clinician group and accepts Medicare assignment. Licensed in Minnesota, Rhode Island and Wisconsin.

Years since qualifying
22
Trained at
University of California, Geffen School of Medicine
Licensed in
MN, RI, WI
In the registry since
2007
Specialties on file
4
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

3059 Voyager Dr
Green Bay, WI 54311-8303
Phone: (920) 965-0345
Fax: (920) 257-4559
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

MOHS-Micrographic Surgery Physician (primary) Taxonomy 207ND0101X · Licence 53110-020 (WI)
Dermatology Physician Taxonomy 207N00000X · Licence 53110-20 (WI)
Dermatology Physician Taxonomy 207N00000X · Licence 51745 (MN)
Dermatology Physician Taxonomy 207N00000X · Licence LP00514 (RI)

Record details

NPI number1497970560
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedApril 16, 2007
Last updated in NPPESMarch 7, 2023
Certification dateSeptember 29, 2020
Mailing address2221 S Webster Ave, Ste 241, Green Bay, WI 54301-2158

Medicare enrollment

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

Medicare specialtyMICROGRAPHIC DERMATOLOGIC SURGERY (MDS)
Also practisesDERMATOLOGY
Medical schoolUNIVERSITY OF CALIFORNIA, GEFFEN SCHOOL OF MEDICINE
Graduated 2004 (22 years in practice)
Group practice New Dermatology Group Ltd — 23 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations5 on file with Medicare

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