LYNN M KITSLAAR RD
NPI 1255316717
Dietitian, Registered in Green Bay, WI

Q: What is Lynn Kitslaar's NPI number?

The NPI number for Lynn Kitslaar is 1255316717. It was assigned to this individual provider in the NPPES registry on December 7, 2005.

Q: What is Lynn Kitslaar's specialty?

The primary specialty registered for this NPI is Dietitian, Registered with taxonomy code 133V00000X.

Q: When was this NPI record last updated?

The NPPES record for Lynn Kitslaar was last updated on August 21, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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.

Active since December 07, 2005Accepts Medicare Assignment

1630 COMMANCHE AVE, GREEN BAY, WI 54313(920) 430-4700(920) 430-4747 Get Directions Write a Review

NPPES record last updated: August 21, 2019. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Aug 21, 2019, Aug 2, 2019, Mar 15, 2019 and 2 more (5 updates tracked since 2017).

On this page

About Lynn M Kitslaar Rd NPPES

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

LYNN M KITSLAAR RD (NPI 1255316717) is an individual dietitian, registered in Green Bay, Wisconsin, licensed in Wisconsin (1399-29) and active in the NPI registry since December 2005. She maintains 2 additional practice locations and is a graduate of Other (1996).

NPPES Registry Identity

NPI1255316717

Entity TypeIndividualFemale

Primary Taxonomy133V00000X

Provider Legal NameLYNN M KITSLAARCredential: RD

Location Address1630 COMMANCHE AVEGreen Bay, WI 54313-5753

Mailing AddressPo Box 22487Green Bay, WI 54305-2487 · (920) 445-7222 · Fax (920) 445-7289

Phone(920) 430-4700

Fax(920) 430-4747

Sole ProprietorNo

Medical School CMSOtherGraduated 1996

Enumeration DateDecember 7, 2005

Last NPPES UpdateAugust 21, 20195 updates tracked since enumeration

✔ NPI 1255316717 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyDietitian, RegisteredDietary & Nutritional Service Providers

Taxonomy Code133V00000X

License✔ Licensed in WI · 1399-29

Definition

A Registered Dietitian (RD)/Registered Dietitian Nutritionist (RDN) is an individual uniquely trained in the science of nutrition and practice of dietetics to design and provide medical nutrition therapy (MNT) and other evidence-based applications of the Nutrition Care Process (NCP) that exemplify the profession's systematic approach to providing high quality nutrition care. Registered dietitians provide MNT for the purpose of disease prevention or management, or to treat or rehabilitate an illness, injury, or condition, with the use of specific, indicated physical and cognitive nutrition care services comprised of one or more of the following aspects of the NCP: nutrition assessment/reassessment, nutrition diagnosis, nutrition intervention (e.g., nutrition counseling, therapeutic diet ordering, and nutrition education) and nutrition monitoring and evaluation.

Also ListedDietitian, Registered · Nutrition, MetabolicTaxonomy 133VN1006X · License 1399-29 (WI)

1630 COMMANCHE AVE, Green Bay, WI 54313

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Secondary Practice Locations 2

Location 1704 S Webster Ave Ste 501Green Bay, WI 54301-3528 · Phone (920) 433-6050 · Fax (920) 433-6049

Location 22714 Riverview DrGreen Bay, WI 54313-6715 · Phone (920) 430-4760 · Fax (920) 430-4774

Other Identifiers 2

Other20110340WI · National Certification Board For Diabetes Educators

Other850912WI · Commission On Dietetic Registration

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, CareSource (Common Ground Healthcare).Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Lynn M Kitslaar Rd 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 ID9335128503

PECOS Enrollment IDI20040720000692

Medicare Billing Reassignment

Medicare enrollment records show Lynn Kitslaar reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Bellin Memorial Hospital Inc

Same address

Family Medicine

1630 COMMANCHE AVE STE 102
Green Bay, WI 54313

Reassigned Medicare billing, Wisconsin enrollment
875 clinicians in this Medicare group

NPI 1912420779 (920) 430-4700

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 54313 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

$0.00 typical visit price

range $53.90 – $163.24

Typical copayment $0.00 (range $13.47 – $40.81)

Most-billed visit code NA

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.

BETHANY J PIOTROWSKI

Physician Assistant