Rebecca J Lietzow, FNP in Forest Lake, MN - Medicare Nurse Practitioner

Rebecca J Lietzow, FNP is a medicare enrolled "Nurse Practitioner - Adult Health" in Forest Lake, Minnesota. She graduated from nursing school in 2015 and has 9 years of diverse experience with area of expertise as Nurse Practitioner. She is a member of the group practice Allina Health System, St. Croix Regional Medical Center and her current practice location is 1540 Lake St S, Forest Lake, Minnesota. You can reach out to her office (for appointments etc.) via phone at (651) 464-7100.

Rebecca J Lietzow is licensed to practice in Minnesota (license number 4164) and she also participates in the medicare program. She accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1538450630.

Contact Information

	Rebecca J Lietzow, FNP
	1540 Lake St S, Forest Lake, MN 55025-2628
	(651) 464-7100
	(651) 241-1515

Map and Direction

Provider's Profile

Full Name	Rebecca J Lietzow
Gender	Female
Speciality	Nurse Practitioner
Experience	9 Years
Location	1540 Lake St S, Forest Lake, Minnesota
Accepts Medicare Assignments	Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.

Medical Education and Training:

Rebecca J Lietzow graduated from nursing school in 2015

NPI Data:

NPI Number: 1538450630
Provider Enumeration Date: 04/22/2011
Last Update Date: 12/08/2023

Medicare PECOS Information:

PECOS PAC ID: 4688974397
Enrollment ID: I20230913002179

Medical Identifiers

Medical identifiers for Rebecca J Lietzow such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1538450630	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
163W00000X	Registered Nurse	141323 (Wisconsin)	Secondary
163WC0200X	Registered Nurse - Critical Care Medicine	R-168269-2 (Minnesota)	Secondary
363LA2200X	Nurse Practitioner - Adult Health	4164 (Minnesota)	Primary
363LF0000X	Nurse Practitioner - Family	6572 (Wisconsin)	Secondary

Medical Facilities Affiliation

Facility Name	Location	Facility Type
St Croix Regional Medical Ctr	Saint croix falls, WI	Hospital

Group Practice Association

Group Practice Name	Group PECOS PAC ID	No. of Members
Allina Health System	4587573613	3101
St. Croix Regional Medical Center	9335032184	147

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. Rebecca J Lietzow allows following entities to bill medicare on her behalf.

Entity Name	Allina Health System
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1457657249 PECOS PAC ID: 4587573613 Enrollment ID: O20221213001713

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. Rebecca J Lietzow 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
Rebecca J Lietzow, FNP 2925 Chicago Ave, Minneapolis, MN 55407-1321 Ph: (612) 262-7374	Rebecca J Lietzow, FNP 1540 Lake St S, Forest Lake, MN 55025-2628 Ph: (651) 464-7100

Reviews and Comments

Nurse Practitioner Nurses in Forest Lake, MN

Mrs. Rimma Faina Winnick, NPC Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 20555 Ingersoll Ave N, Forest Lake, MN 55025 Phone: 651-464-0267
Azie Judith Khan, Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 7211 208th Cir N, Forest Lake, MN 55025 Phone: 515-918-3955
Constance Bih Awason, NP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 19987 Enfield Ave N, Forest Lake, MN 55025 Phone: 763-670-5273
Mrs. Janice Lee James, RN, DNP, FNP-C Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 967 Lake St S, Forest Lake, MN 55025 Phone: 651-464-1113 Fax: 651-464-0853
Hawanie Makonnen, NP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 1540 Lake St S, Forest Lake, MN 55025 Phone: 651-464-7100 Fax: 651-241-1515
Neh Buma Foncham, PSYCHIATRIC NP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 20416 Everton Trl N, Forest Lake, MN 55025 Phone: 651-470-3265
Lisa Marie Forslund, CNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 967 Lake St S, Forest Lake, MN 55025 Phone: 651-464-1113

Rebecca J Lietzow, FNP - Medicare Nurse Practitioner in Forest Lake, MN