NPIMap

Individual provider Active NPI

Michael D. Klein, MD

  • Pediatrics Physician
  • Toledo, OH
National Provider Identifier
1003816539
Registry record updated May 1, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
3508977K Issued in OH
Practice address
2121 Hughes Dr
Ste 620
Toledo, OH 43606-3845
Phone
(419) 291-2126
Fax
(419) 291-6967
NPI assigned
Jul 27, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 1, 2012

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Critical Care Physician 2086S0102X 4301038107 MI
Pediatric Surgery Physician 2086S0120X 4301038107 MI
Pediatrics Physician 208000000X 3508977K OH Primary

Addresses

Primary practice location

2121 Hughes Dr
Ste 620
Toledo, OH 43606-3845

Mailing address

2121 Hughes Dr
Ste 620
Toledo, OH 43606-3845
Phone (419) 291-2126

Other identifiers 16

IdentifierTypeStateIssuer
0650960OtherOHBCMH
4115642MedicaidMI
7697OtherOHHEALTH PLAN OF MI
0650960MedicaidOH
700H262280OtherBLUE CROSS-BLUE CROSS
000000521510OtherOHANTHEM
04671OtherOHPARAMOUNT
147949OtherGLHP
4614571MedicaidMI
MK038107OtherCOMMERCIAL-COMMERCIAL NUMBER
020H277290OtherBLUE CROSS BLUE SHIELD MI
1428394MedicaidMI
5210280MedicaidMI
301415310MedicaidMI
4295600OtherAETNA
MK038107OtherCHAMPUS-CHAMPUS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
3508977KOHMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Michigan Pediatric Surgery Associates P.C. Past Accepting new patients
Promedica Children'S Specialists Pediatrics PastSince Jan 1, 2017 Accepting new patients
SJMH Medical Practice-SMHC Pediatrics Past Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: mklein@direct.dmc.org

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1122422400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1335830400000",
    "number": "1003816539",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2121 HUGHES DR",
            "address_2": "STE 620",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436063845",
            "telephone_number": "419-291-2126",
            "fax_number": "419-291-6967"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2121 HUGHES DR",
            "address_2": "STE 620",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436063845",
            "telephone_number": "419-291-2126",
            "fax_number": "419-291-6967"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLEIN",
        "first_name": "MICHAEL",
        "middle_name": "D.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-27",
        "last_updated": "2012-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0102X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgical Critical Care",
            "state": "MI",
            "license": "4301038107",
            "primary": false
        },
        {
            "code": "2086S0120X",
            "taxonomy_group": "",
            "desc": "Surgery, Pediatric Surgery",
            "state": "MI",
            "license": "4301038107",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "OH",
            "license": "3508977K",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCMH",
            "identifier": "0650960",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4115642",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH PLAN OF MI",
            "identifier": "7697",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0650960",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS-BLUE CROSS",
            "identifier": "700H262280",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000521510",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PARAMOUNT",
            "identifier": "04671",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GLHP",
            "identifier": "147949",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4614571",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COMMERCIAL-COMMERCIAL NUMBER",
            "identifier": "MK038107",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD MI",
            "identifier": "020H277290",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1428394",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5210280",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "301415310",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "4295600",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CHAMPUS-CHAMPUS",
            "identifier": "MK038107",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Toledo, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.