JESSICA L LIETZAN FNP-C
NPI 1043901085
Nurse Practitioner - Family in Manitowoc, WI

Active since May 19, 2023PECOS EnrolledAccepts Medicare Assignment
1650 S 41ST ST, MANITOWOC, WI 54220(920) 320-2436 Get Directions Write a Review

NPPES record last updated: May 19, 2023. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Jessica L Lietzan Fnp-c NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JESSICA L LIETZAN FNP-C (NPI 1043901085) is an individual family provider in Manitowoc, Wisconsin, licensed in Wisconsin (13101-33) and active in the NPI registry since May 2023. She is enrolled in Medicare PECOS, is affiliated with Holy Family Memorial, and is a graduate of Other (2007).

NPPES Registry Identity

NPI1043901085
Entity TypeIndividualFemale
Primary Taxonomy363LF0000X
Provider Legal NameJESSICA L LIETZANCredential: FNP-C
Location Address1650 S 41ST STManitowoc, WI 54220-7316
Mailing Address1650 S 41st StManitowoc, WI 54220-3712
Sole ProprietorNo
Medical School CMSOtherGraduated 2007
Enumeration DateMay 19, 2023
NPPES CertifiedJuly 13, 2022
NPI 1043901085 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
License Licensed in WI · 13101-33
1650 S 41ST ST, Manitowoc, WI 54220

Accepted Insurance

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

Enrolled in Medicare and accepts Medicare assignment

Jessica L Lietzan Fnp-c is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID941663249
PECOS Enrollment IDI20230905002126
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.

Areas of Expertise CMS Part B claims 6

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
139 services115 patients
Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
40 services36 patients
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439
An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.
23 services23 patients
Administration of influenza virus vaccine G0008
The administration of the influenza virus vaccine, also known as the flu shot, is a simple procedure to protect against the flu. A healthcare provider injects a small dose of the vaccine into your arm. This stimulates your immune system to produce antibodies, which will help your body fight off the flu if exposed.
15 services15 patients
Influenza vaccine split virus, preservative free 90662
The Influenza Vaccine Split Virus, preservative-free, is a flu shot to protect against the influenza virus. It is made from parts of inactivated flu viruses and doesn't contain preservatives, reducing potential side effects. It helps your body develop immunity to the flu.
14 services14 patients
New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204
This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.
13 services13 patients

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Holy Family Memorial

Acute Care Hospitals · Manitowoc, WI
3/5 CMS rating
OwnershipVoluntary non-profit - Other
CMS Certification Number520107
Location2300 Western AveManitowoc, WI 54221 · Manitowoc County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 54220 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
$82.92 typical visit price
range $53.90 – $163.24
Typical copayment $20.73 (range $13.47 – $40.81)
Most-billed visit code 99203
Established Patient
$95.41 typical visit price
range $17.40 – $133.76
Typical copayment $23.85 (range $4.35 – $33.44)
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 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Nurse Practitioner (Family)
1650 S 41ST ST
MANITOWOC, WI 54220
Nurse Practitioner (Gerontology)
1650 S 41ST ST
MANITOWOC, WI 54220
Occupational Therapist
1650 S 41ST ST
MANITOWOC, WI 54220
Psychiatry & Neurology (Psychiatry)
1650 S 41ST ST
MANITOWOC, WI 54220
Speech-Language Pathologist
1650 S 41ST ST
MANITOWOC, WI 54220
Physical Therapy Assistant
1650 S 41ST ST
MANITOWOC, WI 54220
Physical Therapist
1650 S 41ST ST
MANITOWOC, WI 54220
Nurse Practitioner
1650 S 41ST ST
MANITOWOC, WI 54220

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 Jessica Lietzan's NPI number?

The NPI number for Jessica Lietzan is 1043901085. It was assigned to this individual provider in the NPPES registry on May 19, 2023.

Where is Jessica Lietzan located?

Jessica Lietzan practices at 1650 S 41st St, Manitowoc, WI 54220. The listed phone number is (920) 320-2436.

What is Jessica Lietzan's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Is Jessica Lietzan enrolled in Medicare?

Yes. Jessica Lietzan is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Jessica Lietzan accept?

Health plans from Anthem Blue Cross and Blue Shield, HealthPartners and Network Health list Jessica Lietzan as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Jessica Lietzan affiliated with any hospitals?

According to CMS data, Jessica Lietzan is affiliated with Holy Family Memorial.

When was this NPI record last updated?

The NPPES record for Jessica Lietzan was last updated on May 19, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.