MRS. DIANE M. LIETZ APRN FNP-C
NPI 1740522101
Nurse Practitioner - Family in Jacksonville, IL

Q: What is Diane Lietz's NPI number?

The NPI number for Diane Lietz is 1740522101. It was assigned to this individual provider in the NPPES registry on March 25, 2013.

Q: What is Diane Lietz's specialty?

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

Q: When was this NPI record last updated?

The NPPES record for Diane Lietz was last updated on March 25, 2013. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 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 March 25, 2013PECOS Enrolled

72.14/100

CMS Quality Rating

800 W STATE ST, JACKSONVILLE, IL 62650(217) 243-2292(217) 243-5359 Get Directions Write a Review

NPPES record last updated: March 25, 2013. Verified against the NPPES registry weekly; last sync: August 09, 2026.

On this page

About Mrs. Diane M. Lietz Aprn Fnp-c NPPES

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

MRS. DIANE M. LIETZ APRN FNP-C (NPI 1740522101) is an individual family provider in Jacksonville, Illinois, licensed in Illinois (209010294) and active in the NPI registry since March 2013. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1740522101

Entity TypeIndividualFemale

Primary Taxonomy363LF0000X

Provider Legal NameMRS. DIANE M. LIETZCredential: APRN FNP-C

Location Address800 W STATE STJacksonville, IL 62650-2290

Mailing Address862 Worrell LnWinchester, IL 62694-3628 · (217) 371-2901

Phone(217) 243-2292

Fax(217) 243-5359

Sole ProprietorNo

Enumeration DateMarch 25, 2013

✔ NPI 1740522101 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 IL · 209010294

800 W STATE ST, Jacksonville, IL 62650

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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mrs. Diane M. Lietz Aprn Fnp-c is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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 62650 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.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

72.14/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Scored as part of a group practice

Quality

74.96

Improvement Activities

Cost

53.06

Other Providers at the Same Location NPPES 5

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

DR. JOHN ANDREW PETERSON M.D.

Family Medicine