JENNIFER ANNE LIETZKE M.D.
NPI 1699701631
Family Medicine in Beaverton, OR

Q: What is Jennifer Lietzke's NPI number?

The NPI number for Jennifer Lietzke is 1699701631. It was assigned to this individual provider in the NPPES registry on June 23, 2006.

Q: What is Jennifer Lietzke's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Q: When was this NPI record last updated?

The NPPES record for Jennifer Lietzke was last updated on February 6, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 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 June 23, 2006PECOS EnrolledAccepts Medicare Assignment

2935 SW CEDAR HILLS BLVD, BEAVERTON, OR 97005(503) 352-6000(503) 352-6080 Get Directions Write a Review

NPPES record last updated: February 6, 2018. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Jennifer Anne Lietzke M.d. NPPES

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

JENNIFER ANNE LIETZKE M.D. (NPI 1699701631) is an individual family medicine provider in Beaverton, Oregon, licensed in Oregon (MD28993) and active in the NPI registry since June 2006. She is enrolled in Medicare PECOS and is a graduate of University Of Chicago, Pritzker School Of Medicine (1999).

NPPES Registry Identity

NPI1699701631

Entity TypeIndividualFemale

Primary Taxonomy207Q00000X

Provider Legal NameJENNIFER ANNE LIETZKECredential: M.D.

Location Address2935 SW CEDAR HILLS BLVDBeaverton, OR 97005-1342

Mailing AddressPo Box 6149Beaverton, OR 97007-0149 · (503) 352-8657 · Fax (503) 352-8658

Phone(503) 352-6000

Fax(503) 352-6080

Sole ProprietorNo

Medical School CMSUniversity Of Chicago, Pritzker School Of MedicineGraduated 1999

Enumeration DateJune 23, 2006

Last NPPES UpdateFebruary 6, 2018

✔ NPI 1699701631 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207Q00000X

License✔ Licensed in OR · MD28993

Definition

Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

2935 SW CEDAR HILLS BLVD, Beaverton, OR 97005

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Other Identifiers 1

Medicaid500634215OR

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include BridgeSpan Health Company, Moda Health Plan, Inc., PacificSource Health Plans and more.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

Jennifer Anne Lietzke M.d. 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 ID4880671429

PECOS Enrollment IDI20130628000758

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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 97005 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

$90.51 typical visit price

range $58.99 – $176.88

Typical copayment $22.62 (range $14.74 – $44.22)

Most-billed visit code 99203

Established Patient

$103.51 typical visit price

range $19.32 – $144.79

Typical copayment $25.87 (range $4.83 – $36.19)

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.

Referred Medical Equipment & Supplies CMS DME claims 2

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253

DME-Other DME · category DE017N

3 suppliers13 claims39 services$3.08 avg. paid by Medicare

Lancets, per box of 100 A4259

DME-Medical/Surgical Supplies · category DA000N

3 suppliers11 claims19 services$0.49 avg. paid by Medicare

Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

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.

DR. CAROLYN LEE GOEBEL M.D.

Family Medicine