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

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: November 01, 2026.

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, billing reassignment, and ordering and referring status from CMS.

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.

Medicare Billing Reassignment

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

Virginia Garcia Memorial Health Center
0.1 mi
Federally Qualified Health Center (FQHC)
2725 SW CEDAR HILLS BLVD STE 200
Beaverton, OR 97005
  • Reassigned Medicare billing, Oregon enrollment
  • 111 clinicians in this Medicare group
NPI 1902067861 (503) 352-6000

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 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
2935 SW CEDAR HILLS BLVD
BEAVERTON, OR 97005
Washington County (503) 352-6000
MS. JUDY ELLEN FLYNN PA
Physician Assistant
2935 SW CEDAR HILLS BLVD
BEAVERTON, OR 97005
Washington County (503) 352-8562
VANESSA H MCKIEL MD
Family Medicine
2935 SW CEDAR HILLS BLVD
BEAVERTON, OR 97005
Washington County (503) 352-6000
MR. JONATHAN RICHARD TARDIFF PA-C
Physician Assistant
2935 SW CEDAR HILLS BLVD
BEAVERTON, OR 97005
Washington County (503) 352-6000
JUAN GABRIEL LOPEZ PHARM.D.
Pharmacist
2935 SW CEDAR HILLS BLVD
BEAVERTON, OR 97005
Washington County (503) 352-6006
JENNIFER STANISLAW
Pharmacist
2935 SW CEDAR HILLS BLVD
BEAVERTON, OR 97005
Washington County (503) 352-6000
SARAH LARIMER RD
Dietitian, Registered
2935 SW CEDAR HILLS BLVD
BEAVERTON, OR 97005
Washington County (503) 352-6000
PETYA GUEORDJEVA M.D.
Family Medicine
2935 SW CEDAR HILLS BLVD
BEAVERTON, OR 97005
Washington County (503) 352-6000

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 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.

Where is Jennifer Lietzke located?

Jennifer Lietzke practices at 2935 SW Cedar Hills Blvd, Beaverton, OR 97005. The listed phone number is (503) 352-6000.

What is Jennifer Lietzke's specialty?

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

Is Jennifer Lietzke enrolled in Medicare?

Yes. Jennifer Lietzke 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 organization bills Medicare for Jennifer Lietzke's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Jennifer Lietzke reassigns Medicare benefits to Virginia Garcia Memorial Health Center (Beaverton, OR). The 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 Jennifer Lietzke's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Jennifer Lietzke accept?

Health plans from BridgeSpan Health Company, Moda Health Plan, Inc., PacificSource Health Plans, Providence Health Plan and Regence BlueCross BlueShield of Oregon list Jennifer Lietzke 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.

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.