Jessica L Lietzan, FNP-C in Manitowoc, WI - Medicare Nurse Practitioner

Jessica L Lietzan, FNP-C is a medicare enrolled "Nurse Practitioner - Family" in Manitowoc, Wisconsin. Her current practice location is 1650 S 41st St, Manitowoc, Wisconsin. You can reach out to her office (for appointments etc.) via phone at (920) 320-2436.

Jessica L Lietzan is licensed to practice in Wisconsin (license number 13101-33) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1043901085.

Contact Information

	Jessica L Lietzan, FNP-C
	1650 S 41st St, Manitowoc, WI 54220-7316
	(920) 320-2436
	Not Available

Map and Direction

Provider's Profile

Full Name	Jessica L Lietzan
Gender	Female
Speciality	Nurse Practitioner - Family
Location	1650 S 41st St, Manitowoc, Wisconsin
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1043901085
Provider Enumeration Date: 05/19/2023
Last Update Date: 05/19/2023

Medicare PECOS Information:

PECOS PAC ID: 0941663249
Enrollment ID: I20230905002126

Medical Identifiers

Medical identifiers for Jessica L Lietzan such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1043901085	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363LF0000X	Nurse Practitioner - Family	13101-33 (Wisconsin)	Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Jessica L Lietzan allows following entities to bill medicare on her behalf.

Entity Name	Froedtert Manitowoc Medical Group, Llc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1437829975 PECOS PAC ID: 2365836954 Enrollment ID: O20220224001282

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Jessica L Lietzan is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Jessica L Lietzan, FNP-C 1650 S 41st St, Manitowoc, WI 54220-3712 Ph: () -	Jessica L Lietzan, FNP-C 1650 S 41st St, Manitowoc, WI 54220-7316 Ph: (920) 320-2436

Reviews and Comments

Nurse Practitioner Nurses in Manitowoc, WI

Barbara J Backus, N.P. Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 1650 S 41st St, Manitowoc, WI 54220 Phone: 920-320-4500 Fax: 920-682-9378
Veronica Mcfarlane, APNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 1650 S 41st St, Manitowoc, WI 54220 Phone: 920-320-2436
Nicole Artamenko, FNP-C Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 1650 S 41st St, Manitowoc, WI 54220 Phone: 920-320-2436
Brenda Stallbaum, APNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 339 Reed Ave, Manitowoc, WI 54220 Phone: 920-320-8600
Angela R Vandewettering, NP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 1111 Bayshore Dr, Manitowoc, WI 54220 Phone: 920-682-6376
Andrew Allen Malkowski, APNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 926 S 8th St, Manitowoc, WI 54220 Phone: 920-683-4230 Fax: 920-683-4902

Jessica L Lietzan, FNP-C - Medicare Nurse Practitioner in Manitowoc, WI