AYESHA FALAK KIETZMAN PA
NPI 1336703461
Physician Assistant in Hudson, FL
NPI Status: Active since April 24, 2019
Contact Information
13944 LAKESHORE BLVD STE C
HUDSON, FL
ZIP 34667
Phone: (727) 605-0252
- Individual
- Female
- Physician Assistant
- Accepts Insurance
- PECOS Enrolled
- Medicare Quality Reporting
About AYESHA KIETZMAN
This page provides the complete NPI Profile along with additional information for Ayesha Kietzman, a primary care provider established in Hudson, Florida with a medical specialization in Physician Assistant. The healthcare provider is registered in the NPI registry with number 1336703461 assigned on April 2019. The practitioner's primary taxonomy code is 363A00000X with license number PA9112195 (FL). The provider is registered as an individual and her NPI record was last updated 6 years ago.
- NPI
- 1336703461
- Provider Name
- AYESHA FALAK KIETZMAN PA
- Other Name
- AYESHA FALAK HUSSAIN
- Other Name Type
- Former Name (1)
- Gender
- Female
- Entity Type
- Individual
- Location Address
- 13944 LAKESHORE BLVD STE C HUDSON, FL 34667
- Location Phone
- (727) 605-0252
- Mailing Address
- 14690 SPRING HILL DR STE 305 SPRING HILL, FL 34609
- Mailing Phone
- (352) 277-5348
- Mailing Fax
- Is Sole Proprietor?
- No
- Enumeration Date
- 04-24-2019
- Last Update Date
- 06-14-2019
- Code Navigator
A primary care provider (PCP) like Ayesha Kietzman sees people with common medical problems. The primary care provider might be a doctor, physician assistant, nurse practitioner or clinic that are usually involved in your long-term care. A PCP might provide preventive care, treat common medical conditions, identify urgent medical problems and refer you to specialists when necessary. Primary care is usually provided in an outpatient facility but if you are admitted to a hospital your PCP may assist in your care. The most common medical conditions seen by primary care providers are: hypertension, upper respiratory tract infections, depression or anxiety, back pain, arthritis, dermatitis, diabetes, urinary tract infections, etc .
Location Map
Secondary Locations
- 14806 Morning Dr
Lutz, FL 33559
(850) 559-4257
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Physician Assistant
- Taxonomy Code
- 363A00000X
- Type
- Physician Assistants & Advanced Practice Nursing Providers
- License No.
- PA9112195
- License State
- FL
- Taxonomy Description
- A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.
Secondary Taxonomies
The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.
| No. | Taxonomy Code | Type | Classification / Specialization |
License No. (State) |
|---|---|---|---|---|
| 1 | 390200000X | Student, Health Care | Student in an Organized Health Care Education/Training Program |
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Complete Gold - HMO
- Complete Gold + Vision + Adult Dental - HMO
- Elite Bronze - HMO
- Elite Bronze + Vision + Adult Dental - HMO
- Elite Silver - HMO
- Elite Silver + Vision + Adult Dental - HMO
- Enhanced Diabetes Care Silver with $0 Drug Options - HMO
- Enhanced Diabetes Care Silver with $0 Drug Options + Vision + Adult Dental - HMO
- Everyday Bronze - HMO
- Everyday Bronze + Vision + Adult Dental - HMO
- Complete Gold - EPO
- Complete Gold + Vision + Adult Dental - EPO
- Elite Bronze - EPO
- Elite Bronze + Vision + Adult Dental - EPO
- Elite Gold - EPO
- Elite Gold + Vision + Adult Dental - EPO
- Elite Silver - EPO
- Elite Silver + Vision + Adult Dental - EPO
- Everyday Bronze - EPO
- Everyday Bronze + Vision + Adult Dental - EPO
- AvMed Entrust Bronze 600 (2025) - HMO
- AvMed Entrust Bronze 650 (2025) - HMO
- AvMed Entrust Expanded Bronze Standard (2025) - HMO
- AvMed Entrust Gold 125 (2025) - HMO
- AvMed Entrust Gold 125 Dental+Vision (2025) - HMO
- AvMed Entrust Gold Standard (2025) - HMO
- AvMed Entrust Platinum 25 (2025) - HMO
- AvMed Entrust Platinum 25 Dental+Vision (2025) - HMO
- AvMed Entrust Platinum Standard (2025) - HMO
- AvMed Entrust Silver 350 (2025) - HMO
- Bronze 4 - HMO
- Bronze 8 - HMO
- Gold 1 - HMO
- Gold 1 with Adult Vision Services - HMO
- Gold 8 - HMO
- Silver 1 - HMO
- Silver 1 with Adult Vision Services - HMO
- Silver 12 with First 4 Primary Care Visits Free - HMO
- Silver 8 - HMO
- Silver 9 - HMO
- Bronze Classic 4700 - EPO
- Bronze Classic Standard - EPO
- Bronze Elite + PCP Saver Plus - EPO
- Gold Classic Standard - EPO
- Gold Elite - EPO
- Gold Elite Saver Plus - EPO
- Secure - EPO
- Silver Classic Standard - EPO
- Silver Elite - EPO
- Silver Simple Chronic Care CKM - EPO
- UHC Bronze Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care) - HMO
- UHC Bronze Standard - HMO
- UHC Bronze Value ($0 Virtual Urgent Care) - HMO
- UHC Gold Advantage+ ($0 Virtual Urgent Care, $1 Tier 2 Rx, Dental + Vision) - HMO
- UHC Gold Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, $3 Tier 2 Rx) - HMO
- UHC Gold Standard - HMO
- UHC Silver Advantage ($0 Virtual Urgent Care, $1 Tier 2 Rx) - HMO
- UHC Silver Advantage+ ($0 Virtual Urgent Care, $1 Tier 2 Rx, Dental + Vision) - HMO
- UHC Silver Standard - HMO
- UHC Silver Value ($0 Virtual Urgent Care, $3 Tier 2 Rx) - HMO
- Wellpoint Essential Bronze 5500 ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
- Wellpoint Essential Bronze 5500 Adult Dental/Vision ($0 Virtual PCP+$0 Select Drugs+Incentives) - HMO
- Wellpoint Essential Bronze 6000 ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
- Wellpoint Essential Bronze 7500 ($0 Virtual PCP + $0 Select Drugs + Incentives) Standard - HMO
- Wellpoint Essential Catastrophic 9200 (+ Incentives) - HMO
- Wellpoint Essential Gold 1400 ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
- Wellpoint Essential Gold 1500 ($0 Virtual PCP + $0 Select Drugs + Incentives) Standard - HMO
- Wellpoint Essential Gold 800 ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
- Wellpoint Essential Gold 800 Adult Dental/Vision ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
- Wellpoint Essential Silver 1850 ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Medicare Participation & PECOS Enrollment Status
Ayesha Kietzman is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.
What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.
Is the provider registered in PECOS? Yes
Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes
Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes
Eligible to Order or Refer a Home Health Agency (HHA): Yes
Eligible to Order or Refer Power Mobility Devices: Yes
Physician Visit Costs
The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.
For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.
The prices below reflect the costs for new and established patients in the 34667 ZIP code area.
New Patients Visit Costs *
The most utilized procedure code for new patients office visits is 99203
- Average New Patient Price $87.62
- Minimum New Patient Price $56
- Maximum New Patient Price $171.84
- Average New Patient Copayment $21.9
- Minimum New Patient Copayment $14
- Maximum New Patient Copayment $42.96
Established Patients Visit Costs *
The most utilized procedure code for established patients office visits is 99213
- Average Established Patient Price $70.04
- Minimum Established Patient Price $17.57
- Maximum Established Patient Price $139.16
- Average Established Patient Copayment $17.51
- Minimum Established Patient Copayment $4.39
- Maximum Established Patient Copayment $34.79
* The physician office visit costs information is generated by statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.
MIPS Quality Measures
The following performance measures were reported under the Merit-Based Incentive Payment System (MIPS) and Qualified Clinical Data Registry (QCDR) quality measures program.
| Quality Measure | Performance | Number of Patients |
|---|---|---|
| Closing the Referral Loop: Receipt of Specialist Report | 6% | 422 |
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NPI Validation Check Digit Calculation
The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.
| Start with the original NPI number, the last digit is the check digit and is not used in the calculation. | |||||||||
| 1 | 3 | 3 | 6 | 7 | 0 | 3 | 4 | 6 | 1 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 3 | 6 | 6 | 14 | 0 | 6 | 4 | 12 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 3 + 6 + 6 + 1 + 4 + 0 + 6 + 4 + 1 + 2 + 24 = 59 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 60 - 59 = 1 | 1 | ||||||||
The NPI number 1336703461 is valid because the calculated check digit 1 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the Same Location
The following provider is registered at the same or nearby location.
| NPI | Name / Type | Taxonomy | Address |
|---|---|---|---|
| 1104308329 | MARK FELIX ROLDAN ARNP Individual | Nurse Practitioner (Gerontology) | 13944 LAKESHORE BLVD STE C HUDSON, FL 34667 (727) 605-0252 |
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1336703461, enumerated in the NPI registry as an "individual" on April 24, 2019
The provider is located at 13944 Lakeshore Blvd Ste C Hudson, Fl 34667 and the phone number is (727) 605-0252
The provider's speciality is Physician Assistant with taxonomy code 363A00000X
The provider might be accepting Accepts: Ambetter Health, Ambetter of Alabama, AvMed,. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.
Yes, as of June 20, 2025 the provider is registered in PECOS and is eligible to order health care services or supplies for Medicare patients. If you are a beneficiary the provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.
Medicare beneficiaries should expect a typical cost of $87.62 with an average copayment of $21.9 for new patient appointments. Established patients should expect a typical charge of $70.04 and an average copayment of 17.51. Please review your insurance plan or contact the provider directly to determine your specific costs.
This NPI record was last updated on April 24, 2019. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
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