Kristin K. Lietzau, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

4671-23 Issued in WI

Practice address

Beloit Clinic
1905 E. Huebbe Parkway
Beloit, WI 53511-1842

Phone

(608) 364-2230

Fax

(608) 363-7394

NPI assigned

Apr 4, 2019

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in WI, IL2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Specialty

Physician Assistant

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Beloit Health System IncGroup PAC ID 8224947858, 138 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Beloit Health System Hospital, Beloit, WI, CCN 520100

Merit-based Incentive Payment System (MIPS)

Final score

80.93 of 100Reported as group

Quality

64.82

Promoting interoperability

100

Improvement activities

40

Cost

71.63

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Beloit Health System Inc

  dba BHS Clinics

  • General Practice Physician
  • Beloit, WI
  • NPI 1679616361
  Medicare reassignment Care Compare group NPD
• Beloit Health System Inc

  dba Northpointe

  • General Practice Physician
  • Roscoe, IL
  • NPI 1841485984
  Medicare reassignment
• Beloit Clinic, S.C.

  • Internal Medicine Physician
  • Beloit, WI
  • NPI 1548345887
  NPD
• Beloit Health System, Inc

  dba Hendricks Family Heart Hospital

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Beloit, WI
  • NPI 1568677417
  NPD
• Beloit Health System, Inc

  dba janesville medical center

  • Family Medicine Physician
  • Janesville, WI
  • NPI 1407999337
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Beloit Health System Inc

  dba Beloit Memorial Hospital

  • General Acute Care Hospital
  • Beloit, WI
  • NPI 1982780094
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1554336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1559001600000",
    "number": "1154883593",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "BELOIT CLINIC",
            "address_2": "1905 E. HUEBBE PARKWAY",
            "city": "BELOIT",
            "state": "WI",
            "postal_code": "535111842",
            "telephone_number": "608-364-2293",
            "fax_number": "608-364-5452"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "BELOIT CLINIC",
            "address_2": "1905 E. HUEBBE PARKWAY",
            "city": "BELOIT",
            "state": "WI",
            "postal_code": "535111842",
            "telephone_number": "608-364-2230",
            "fax_number": "608-363-7394"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIETZAU",
        "first_name": "KRISTIN",
        "middle_name": "K.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-04",
        "last_updated": "2019-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207XX0005X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": "IL",
            "license": "085.007026",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085-007026",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WI",
            "license": "4671-23",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Taylor Leibfried
• Caitlynn Marie Lemke, SAC-IT
• Erin Leonhardt, APSW
• Kristin Lewis, PTA
• Julia A Licary, LPN
• Roger G Lim, MD
• Laura Linek
• Jaclyn Lineman, PHARMD
• Marek J Lisek, D.O.
• Thomas J Lisk, MD

• Physician Assistant in Beloit, WI
• Providers in Beloit, WI by specialty
• Physician Assistant in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.