Kristin K. Lietzau, PA

Individual provider Sports Medicine (Orthopaedic Surgery) Physician · NPI 1154883593

Kristin K. Lietzau, PA is a Physician Assistant in Beloit, Wisconsin. Qualified in 2018, 8 years ago. Practices with Beloit Health System Inc, a 141-clinician group and accepts Medicare assignment. Licensed in Illinois and Wisconsin.

Years since qualifying: 8
Licensed in: IL, WI
In the registry since: 2019
Specialties on file: 3

What do these letters mean?

PA — Physician Assistant: A licensed clinician who examines, diagnoses and treats under a physician's supervision.

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Practice location Partly verified

Some contact details are missing from the federal record.

Beloit Clinic 1905 E Huebbe Pkwy
Beloit, WI 53511-1842
Phone: (608) 364-2230
Fax: (608) 363-7394

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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary)	Taxonomy 363A00000X · Licence 4671-23 (WI)
Sports Medicine (Orthopaedic Surgery) Physician	Taxonomy 207XX0005X · Licence 085.007026 (IL)
Physician Assistant	Taxonomy 363A00000X · Licence 085-007026 (IL)

Record details

NPI number	1154883593
Entity type	Individual (Type 1)
Gender	Female
Credentials	PA
Sole proprietor	No
NPI enumerated	April 4, 2019
Last updated in NPPES	May 28, 2019

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialty	PHYSICIAN ASSISTANT
Medical school	OTHER
Graduated	2018 (8 years in practice)
Group practice	Beloit Health System Inc — 141 clinicians
Accepts Medicare assignment	Yes — accepts the Medicare-approved amount
Practice locations	6 on file with Medicare