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LAUREL KIETZMAN MD
NPI 1336331222
Emergency Medicine in Pontiac, IL

Active since August 14, 2007PECOS EnrolledAccepts Medicare Assignment
2500 W REYNOLDS ST, PONTIAC, IL 61764(815) 842-2828 Get Directions Write a Review

NPPES record last updated: July 24, 2024. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Laurel Kietzman Md NPPES

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

LAUREL KIETZMAN MD (NPI 1336331222) is an individual emergency medicine provider in Pontiac, Illinois, licensed in Illinois (036119129) and active in the NPI registry since August 2007. She is enrolled in Medicare PECOS, is affiliated with Presence St Marys Hospital, and maintains a secondary practice location in Wheaton.

NPPES Registry Identity

NPI1336331222
Entity TypeIndividualFemale
Primary Taxonomy207P00000X
Provider Legal NameLAUREL KIETZMANCredential: MD
Location Address2500 W REYNOLDS STPontiac, IL 61764-9774
Mailing Address2500 W Reynolds StPontiac, IL 61764-9774 · (815) 842-2828
Phone(815) 842-2828
Sole ProprietorNo
Medical School CMSLoyola University Of Chicago, Stritch School Of MedicineGraduated 1986
Enumeration DateAugust 14, 2007
Last NPPES UpdateJuly 24, 2024
NPPES CertifiedJuly 24, 2024
✔ NPI 1336331222 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyEmergency MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207P00000X
License✔ Licensed in IL · 036119129
Definition
An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury.
2500 W REYNOLDS ST, Pontiac, IL 61764
Open in Google Maps ↗

Secondary Practice Location 1

Location 1515 Irving StWheaton, IL 60187 · Phone (630) 752-5072

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of Texas.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

Laurel Kietzman Md 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 ID7214108273
PECOS Enrollment IDI20110922000662
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.

Medicare Billing Reassignments

6

Medicare enrollment records show Laurel Kietzman reassigns Medicare billing to 6 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Cepamerica Illinois LLP
32 mi
Emergency Medicine
2200 E WASHINGTON ST
Bloomington, IL 61701
  • Reassigned Medicare billing, Illinois enrollment
  • 982 clinicians in this Medicare group
NPI 1497435242 (309) 661-5111
Methodist Medical Center Of Illinois
52 mi
General Acute Care Hospital
221 NE GLEN OAK AVE
Peoria, IL 61636
  • Reassigned Medicare billing, Illinois enrollment
  • Also billed through NPI 1265966048 (Illinois)
  • 693 clinicians in this Medicare group
NPI 1164474755 (309) 672-5522
Osf Multi-Specialty Group
54 mi
Internal Medicine
8600 N STATE ROUTE 91
Peoria, IL 61615
  • Reassigned Medicare billing, Illinois enrollment
  • 2,944 clinicians in this Medicare group
NPI 1154908929 (309) 683-5050
Carle Health Medical Group
57 mi
Internal Medicine
611 W PARK ST
Urbana, IL 61801
  • Reassigned Medicare billing, Illinois enrollment
  • Medicare enrollment name: Carle Health Care Incorporated
  • 2,516 clinicians in this Medicare group
NPI 1154653947 (217) 383-8300
Cgh Medical Center
85 mi
General Acute Care Hospital
100 E LE FEVRE RD
Sterling, IL 61081
  • Reassigned Medicare billing, Illinois enrollment
  • 356 clinicians in this Medicare group
NPI 1902854623 (815) 625-0400
Valley Emergency Care Management Inc
  • Reassigned Medicare billing, Illinois enrollment
  • 55 clinicians in this Medicare group
No phone listed

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

Areas of Expertise CMS Part B claims 4

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.

Emergency department visit with high level of medical decision making 99285
An emergency department visit for severe conditions is when you urgently seek medical help due to serious health issues. These could be severe injuries, breathing problems, unbearable pain, or sudden severe illness. Doctors and nurses will provide immediate care to stabilize your condition.
202 services196 patients
Electrocardiogram (ecg) 1 to 3 leads with review by physician only 93042
An Electrocardiogram (ECG) is a non-invasive test that records the electrical activity of your heart. 1 to 3 leads or sensors are placed on your body to capture this data. A physician then reviews the results to evaluate your heart's health.
103 services101 patients
Emergency department visit with moderate level of medical decision making 99284
An emergency department visit for a high-severity issue means you're experiencing a serious health problem that needs immediate attention. This could be a severe injury, serious illness, or life-threatening condition. Medical professionals will provide urgent care to stabilize your condition.
64 services61 patients
Critical care, first 30-74 minutes 99291
Critical care involves immediate and constant attention by a team of specially-trained health professionals. It's for patients with life-threatening conditions, requiring first 30-74 minutes of intense monitoring and treatment.
27 services26 patients

Hospital Affiliations CMS Care Compare 2

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

Presence St Marys Hospital

Acute Care Hospitals · Kankakee, IL
4/5 CMS rating
OwnershipVoluntary non-profit - Church
CMS Certification Number140155
Location500 W Court StKankakee, IL 60901 · Kankakee County
Emergency services Birthing friendly

Methodist Medical Center Of Illinois

Acute Care Hospitals · Peoria, IL
2/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number140209
Location221 N E Glen Oak AvePeoria, IL 61636 · Peoria County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 61764 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
$85.71 typical visit price
range $54.80 – $168.44
Typical copayment $21.42 (range $13.70 – $42.11)
Most-billed visit code 99203
Established Patient
$97.25 typical visit price
range $17.16 – $136.56
Typical copayment $24.31 (range $4.29 – $34.14)
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.

EMILY RUFF
Occupational Therapist
2500 W REYNOLDS ST
PONTIAC, IL 61764
Livingston County (815) 842-2828
SAINT JAMES HOSPITAL
Medicare Defined Swing Bed Unit
2500 W REYNOLDS ST
PONTIAC, IL 61764
Livingston County (815) 847-2828
WILLIAM LEE CHANG II
Physician Assistant
2500 W REYNOLDS ST
PONTIAC, IL 61764
Livingston County (815) 844-4062
SARA PILLER
Nurse Practitioner (Family)
2500 W REYNOLDS ST
PONTIAC, IL 61764
Livingston County (815) 842-2828
BECKY DOTTERER
Occupational Therapy Assistant
2500 W REYNOLDS ST
PONTIAC, IL 61764
Livingston County (815) 842-2828
MRS. ALLISON HOOPER OTR/L
Occupational Therapist
2500 W REYNOLDS ST
PONTIAC, IL 61764
Livingston County (815) 842-2828
MRS. MELISSA RENEE PINA CDS
Developmental Therapist
2500 W REYNOLDS ST
PONTIAC, IL 61764
Livingston County (815) 842-2828
TAYLOR MORGAN MILES MD
Family Medicine
2500 W REYNOLDS ST
PONTIAC, IL 61764
Livingston County (815) 842-2828

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 Laurel Kietzman's NPI number?

The NPI number for Laurel Kietzman is 1336331222. It was assigned to this individual provider in the NPPES registry on August 14, 2007.

Where is Laurel Kietzman located?

Laurel Kietzman practices at 2500 W Reynolds St, Pontiac, IL 61764. The listed phone number is (815) 842-2828.

What is Laurel Kietzman's specialty?

The primary specialty registered for this NPI is Emergency Medicine with taxonomy code 207P00000X.

Is Laurel Kietzman enrolled in Medicare?

Yes. Laurel Kietzman 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.

Which organizations bill Medicare for Laurel Kietzman's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Laurel Kietzman reassigns Medicare benefits to 6 organizations: Cepamerica Illinois LLP (Bloomington, IL), Methodist Medical Center Of Illinois (Peoria, IL), Osf Multi-Specialty Group (Peoria, IL), Carle Health Medical Group (Urbana, IL), Cgh Medical Center (Sterling, IL) and 1 more organization, listed in the Medicare section above. Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Laurel Kietzman's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Laurel Kietzman accept?

Health plans from Blue Cross and Blue Shield of Texas list Laurel Kietzman 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 Laurel Kietzman affiliated with any hospitals?

According to CMS data, Laurel Kietzman is affiliated with Presence St Marys Hospital and Methodist Medical Center Of Illinois.

When was this NPI record last updated?

The NPPES record for Laurel Kietzman was last updated on July 24, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.