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MARCIA KAY LIDTKE FNP-C
NPI 1972716496
Nurse Practitioner - Family in Provo, UT

Active since May 08, 2007PECOS EnrolledAccepts Medicare Assignment
750 N FREEDOM BLVD, PROVO, UT 84601(801) 373-9656(801) 373-2978 Get Directions Write a Review

NPPES record last updated: January 19, 2017. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Marcia Kay Lidtke Fnp-c NPPES

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

MARCIA KAY LIDTKE FNP-C (NPI 1972716496) is an individual family provider in Provo, Utah, licensed in Utah (9836853-4405) and active in the NPI registry since May 2007. She is enrolled in Medicare PECOS and is a graduate of Other (2002).

NPPES Registry Identity

NPI1972716496
Entity TypeIndividualFemale
Primary Taxonomy363LF0000X
Provider Legal NameMARCIA KAY LIDTKECredential: FNP-C
Location Address750 N FREEDOM BLVDProvo, UT 84601-1677
Mailing Address23 E Emerald CtSaratoga Springs, UT 84045-8141 · (408) 813-0780
Phone(801) 373-9656
Fax(801) 373-2978
Sole ProprietorYes
Medical School CMSOtherGraduated 2002
Enumeration DateMay 8, 2007
Last NPPES UpdateJanuary 19, 2017
✔ NPI 1972716496 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
Licenses✔ Licensed in UT · 9836853-4405✔ Licensed in CA · 13626
750 N FREEDOM BLVD, Provo, UT 84601
Open in Google Maps ↗

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include BridgeSpan Health Company, Molina Healthcare, Regence BlueCross BlueShield of Utah.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

Marcia Kay Lidtke Fnp-c 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 ID7214010271
PECOS Enrollment IDI20170301002328
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 Marcia Lidtke reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Wasatch Behavioral Health Special Service District
Same address
Community/Behavioral Health
750 N FREEDOM BLVD, SUITE 300
Provo, UT 84601
  • Reassigned Medicare billing, Utah enrollment
  • 141 clinicians in this Medicare group
NPI 1356357115 (801) 373-4760

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 84601 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
$84.41 typical visit price
range $54.34 – $166.03
Typical copayment $21.10 (range $13.58 – $41.50)
Most-billed visit code 99203
Established Patient
$96.35 typical visit price
range $17.23 – $135.20
Typical copayment $24.08 (range $4.30 – $33.80)
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.

ELIZA RACHELLE GEDGE PH.D., LP
Psychologist (Clinical)
750 N FREEDOM BLVD
PROVO, UT 84601
Utah County (801) 373-0639
WASATCH MENTAL HEALTH
Clinic/Center (Adolescent and Children Mental Health)
750 N FREEDOM BLVD
PROVO, UT 84601
Utah County (801) 373-4760
JUSTINE CADAYONG EGGLESTON
Social Worker (Clinical)
750 N FREEDOM BLVD
PROVO, UT 84601
Utah County (801) 373-4760
SARAH FARIA
Case Manager/Care Coordinator
750 N FREEDOM BLVD
PROVO, UT 84601
Utah County (801) 373-4760
MEGAN NICHOLS
Case Manager/Care Coordinator
750 N FREEDOM BLVD
PROVO, UT 84601
Utah County (801) 373-4760
VICTORIA RYALS
Student in an Organized Health Care Education/Training Program
750 N FREEDOM BLVD
PROVO, UT 84601
Utah County (801) 373-4760
KAMERYA HANOHANO
Peer Specialist
750 N FREEDOM BLVD
PROVO, UT 84601
Utah County (801) 373-4760
ALLISON RAMIREZ
Peer Specialist
750 N FREEDOM BLVD
PROVO, UT 84601
Utah County (801) 373-4760

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 Marcia Lidtke's NPI number?

The NPI number for Marcia Lidtke is 1972716496. It was assigned to this individual provider in the NPPES registry on May 8, 2007.

Where is Marcia Lidtke located?

Marcia Lidtke practices at 750 N Freedom Blvd, Provo, UT 84601. The listed phone number is (801) 373-9656.

What is Marcia Lidtke's specialty?

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

Is Marcia Lidtke enrolled in Medicare?

Yes. Marcia Lidtke 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 Marcia Lidtke's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Marcia Lidtke reassigns Medicare benefits to Wasatch Behavioral Health Special Service District (Provo, UT). 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 Marcia Lidtke's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Marcia Lidtke accept?

Health plans from BridgeSpan Health Company, Molina Healthcare and Regence BlueCross BlueShield of Utah list Marcia Lidtke 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 Marcia Lidtke was last updated on January 19, 2017. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 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.