Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Lisa Kotzen, PA

Individual provider Physician Assistant · NPI 1174845846

Lisa Kotzen, PA is a Physician Assistant in Royal Oak, Michigan. Qualified in 2009, 17 years ago. Practices with Beaumont Medical Group- Specialty Services, a 858-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Michigan.

Years since qualifying
17
Licensed in
MI
In the registry since
2010
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 Address checks out

3555 W 13 Mile Rd Ste N120
Royal Oak, MI 48073-6710
Phone: (855) 863-8761
Fax: (248) 551-2301
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 750 Stephenson Hwy, Troy, MI 48083-1103 — (248) 577-3522

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 5601005577 (MI)

Record details

NPI number1174845846
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA
Sole proprietorNo
NPI enumeratedFebruary 23, 2010
Last updated in NPPESJanuary 22, 2021
Certification dateJanuary 22, 2021

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2009 (17 years in practice)
Group practice Beaumont Medical Group- Specialty Services — 858 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

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