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Active NPI 1366624330 Individual Practitioner Male Practitioner

Dr. Eric E. Liedtke , DO

Surgery • Ogden, UT

✓ Accepts Medicare Assignment

Professional Overview & Biography Verified Profile Summary

Dr. Eric Liedtke, DO is a certified Surgery practicing in Ogden, UT. With approximately 21 years of clinical experience since graduating from Lake Erie College Of Osteopathic Medicine, Erie in 2005, Dr. Liedtke delivers high-quality medical care to the local community at 4650 HARRISON BLVD.

Dr. Liedtke is affiliated with Ogden Clinic Specialty Services Llc and accepts Medicare assignment.

Frequently performed procedures and clinical services include subsequent hospital care with moderate levelof medical decision making, if using time, at least, new patient outpatient office visit, established patient outpatient office visit. Full Medicare procedure pricing transparency rates and service volume details are listed on this profile.

Practice Location & Contact Primary Location

Practice Address

4650 Harrison Blvd

Ogden, UT 844034303

Telephone 8014753010
Associated Practice Facility / Clinic
🏢 Ogden Clinic Pc Facility NPI 1578550083

Medicare Profile & Education

Medical School

Lake Erie College Of Osteopathic Medicine, Erie

Graduation Year

2005

Medicare Assignment

✓ Accepts Assignment

Telehealth Flag

In-Person Only

Specialty Benchmarks & Practice Insights

Comparative analytics for Surgery in Ogden, UT

Senior Veteran Specialist (>20 Yrs)
Practitioner Clinical Experience
21 Yrs -3.6 yrs vs City Avg
City Avg: 24.6 Yrs
State Avg: 21.4 Yrs
Regional Practice Density
14 Specialists

Practicing in Ogden, UT (278 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
36.9% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Clinical Seniority & Experience Comparison

Dr. Liedtke (21 Years) 21 Yrs
Ogden Specialty Average (24.6 Years) 24.6 Yrs

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2024)
Reporting Year:
HCPCS Code & Description Services Patients Submitted Charge Medicare Allowed
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes
27 11 $109.00 $74.98
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more
22 22 $254.00 $158.75
99215 Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more
22 18 $255.00 $171.47
99223 Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes
16 16 $296.00 $155.79
99222 Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes
12 12 $192.00 $124.07
99205 New patient office or other outpatient visit with a high level of medical decision making, if using time, 60 minutes or more
11 11 $312.00 $209.92

Medical Specialties & State Licenses

CMS Verified: 2021-06-15
Surgery Primary Specialty

NUCC Taxonomy Code: 208600000X

State License UT 12168421-1204

A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery.

Surgery

NUCC Taxonomy Code: 208600000X

State License CA 20A12096

A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery.

Surgery

NUCC Taxonomy Code: 208600000X

State License WA OP60582410

A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery.

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID
1366624330 (UT)
Commercial Insurance / Payer ID Rr Medicare
P01526646 (WA)

Hospital & Practice Group Affiliations

Ogden Clinic Specialty Services Llc

4650 Harrison Blvd, Ogden, UT 844034303

Phone: 8014753482

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

8 Associated Practitioners
Dr. Casey Stelter , MD

Family Medicine

NPI 1073607222

Doctor of Medicine (M.D.)

Carson Close , PA-C

Physician Assistant

NPI 1073981437

Physician Assistant (Certified)

Jenna Rhoton , PA-C

Physician Assistant

NPI 1134769375

Physician Assistant (Certified)

Dr. Mary Mason , DO

Family Medicine

NPI 1144382334

Doctor of Osteopathic Medicine (D.O.)

Dr. Benjamin Christiansen , PsyD

Clinical Neuropsychologist

NPI 1457632820

Doctor of Psychology (Psy.D.)

Eleanore Weese , NP

Nurse Practitioner

NPI 1588136485

Nurse Practitioner

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

9 Historical Events
📍
Updated Practice Location June 15, 2021

Registered at 4650 HARRISON BLVD, OGDEN, UT 844034303 (Tel: 8014753010)

📍
Updated Business Mailing Address June 15, 2021

Registered at PO BOX 5546, DENVER, CO 802175546 (Tel: 8014753500)

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) June 15, 2021

Surgery (License #12168421-1204 in UT)

NPI Profile Active November 13, 2015

NPI status registered as active in NPPES database

📍
Updated Practice Location November 13, 2015

Registered at 820 N CHELAN AVE, WENATCHEE, WA 988012028 (Tel: 5096638711)

📍
Updated Business Mailing Address November 13, 2015

Registered at 820 N CHELAN AVE, WENATCHEE, WA 988012028 (Tel: 5096638711)

👤
Provider Name / Credentials Updated November 13, 2015

Recorded as ERIC LIEDTKE, DO

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) November 13, 2015

Surgery (License #OP60582410 in WA)

🟢
Initial NPI Registration & Enumeration December 03, 2007

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1366624330
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: December 03, 2007
Last Update: June 15, 2021
Sole Proprietor: No

Mailing Address

Po Box 5546

Denver, CO 802175546

Phone: 8014753500

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.