ROBERT LIEDTKE (M.D.) – Family Medicine Physician, NPI 1780657353

ROBERT LIEDTKE (M.D.) is a healthcare provider. based in Sussex, Wisconsin. specializing in Family Medicine Physician. They hold the professional credentials M.D.. They hold a License No. 38057 (WI). The NPI Number for ROBERT LIEDTKE (M.D.) is 1780657353

Main info

Male
31 Years Of Experience
Accepts Medicare Assignment
Name
ROBERT LIEDTKE (M.D.)
NPI
1780657353
Phone
(414) 335-6921
Address
N82W23422 FIVE IRON WAY
Enumeration Date
13 February 2006
Last Update Date
1 June 2023

Doctor Profile

Medical School Name
OTHER
Secondary Phone
6513421039
Graduation Year
1995 (31 years ago)
PAC ID
0648182204
Group Practice PAC ID
7719296789
Professional Enrollment ID
I20100219000713
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience64
Completeness75
Years active:20State licenses:1Digital endpointsOther names

Provider Addresses for ROBERT LIEDTKE (M.D.)

  • N82W23422 FIVE IRON WAY

    SUSSEX, WI 530891556

    Phone: (414) 335-6921

    Type: Mailing

  • Main Street North, Stillwater, Washington County, Minnesota, 55082, United States

    STILLWATER, MN 550826788

    Phone: (651) 342-1039

    Fax: (651) 342-1428

    Type: Mailing

  • North Water Street, Park East, Milwaukee, Milwaukee County, Wisconsin, 53202, United States

    MILWAUKEE, WI 53202

    Phone: (651) 342-1039

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

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: 2024-10-24

PECOS data refreshed: 2026-05-27

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

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99347Residence visit for established patient with straightforward medical decision making, per day, if using time, at least 15 minutes241238$0
View full utilization report →

Insurance plans in this area (ZIP 53089)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 7719296789View full group profile
NameSpecialtyState
Nurse PractitionerWI
Nurse PractitionerWI
Family PracticeMN
Nurse PractitionerWI
Nurse PractitionerWI
Family PracticeMN
Pediatric Medicine, Internal MedicineWI
Nurse PractitionerWI
Family PracticeWI
Nurse PractitionerWI

Reviews

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Frequently asked questions

Can I use this page to confirm ROBERT LIEDTKE (M.D.)'s NPI?
Yes. ROBERT LIEDTKE (M.D.) is listed with NPI 1780657353 in the public NPI dataset.
Does CMS list ROBERT LIEDTKE (M.D.) as active?
Yes — ROBERT LIEDTKE (M.D.) is active in the NPI listing used on this page.
What taxonomy line describes ROBERT LIEDTKE (M.D.)?
For research purposes, treat ROBERT LIEDTKE (M.D.) as Family Medicine Physician in this dataset. Clinical services aligned with this taxonomy classification.
What address line appears for ROBERT LIEDTKE (M.D.)?
ROBERT LIEDTKE (M.D.)'s geographic hint is Sussex, Wisconsin in our summary view.
What does 'Individual Provider' mean on this profile?
Entity type tells you whether the number belongs to a person or an organization.

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