LISA MARIE TETZLAFF (FNP-C) – Family Nurse Practitioner, NPI 1174854400
Family Nurse Practitioner
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
8,105 NURSE PRACTITIONER in MI
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Provider Addresses for LISA MARIE TETZLAFF (FNP-C)
9789, West Baird Street, Brimley, Superior Township, Chippewa County, Michigan, 49715, United States
BRIMLEY, MI 497159291
Phone: (906) 203-6042
Type: Mailing
Newberry Area School, 700, Newberry Avenue, Newberry, Luce County, Michigan, 49868, United States
NEWBERRY, MI 498681503
Phone: (906) 293-3226
Fax: (877) 743-0490
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 1 Open Payments records for all available years, with a total value of $33.
Total Amount is formed as General ($33) + Research ($0) + Ownership ($0) = $33.
Last reported payment date: 2023-09-26 • Largest payer in this snapshot: GlaxoSmithKline, LLC. ($33).
Total Amount
$33
General + Research + Ownership
Payments
1
Total payment records
General Amount
$33
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2023-09-26
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| GlaxoSmithKline, LLC. | $33 |
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2016-03-11
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20160311001465 | I | Nurse Practitioner | MI | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 99215 | Established patient office or other outpatient visit, 40-54 minutes | 24 | 20 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 14 | 14 | $0 |
Insurance plans in this area (ZIP 49715)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Physician Assistant | IN | |
| Physician Assistant | MI | |
| Physician Assistant | MI | |
| D E R M A T O L O G Y | MI | |
| Pain Management | IL | |
| - | MI | |
| E N D O C R I N O L O G Y | MI | |
| O B S T E T R I C S/ G Y N E C O L O G Y | MI | |
| Hospitalist, Internal Medicine | MI | |
| - | MI |
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