David A Kloss, M.D.

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

68403 Issued in WI

Practice address

100 County Road B
Shawano, WI 54166-7072

Phone

(715) 524-2161

Fax

(715) 524-8164

NPI assigned

Jun 23, 2006

Last updated

Jun 5, 2019By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 9

Medicare fee-for-service enrollment

Enrolled in MN, WI2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: dkloss28234@direct.centracare.com

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

• Astera Health

  dba Astera Health Wadena Clinic

  • Rural Health Clinic/Center
  • Wadena, MN
  • NPI 1134305162
  Medicare reassignment NPD
• Astera Health

  dba Tri- County Health Care

  • Critical Access Hospital
  • Wadena, MN
  • NPI 1477545333
  Medicare reassignment NPD
• Astera Health

  dba Astera Health Henning Clinic

  • Rural Health Clinic/Center
  • Henning, MN
  • NPI 1194711986
  NPD

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

{
    "created_epoch": "1151020800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1559692800000",
    "number": "1003842915",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "415 JEFFERSON ST NORTH",
            "address_2": "TRI-COUNTY HOSPITAL",
            "city": "WADENA",
            "state": "MN",
            "postal_code": "564821296",
            "telephone_number": "218-631-3510",
            "fax_number": "218-631-7507"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 COUNTY ROAD B",
            "city": "SHAWANO",
            "state": "WI",
            "postal_code": "541667072",
            "telephone_number": "715-524-2161",
            "fax_number": "715-524-8164"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "415 Jefferson St North",
            "address_2": "Tri-County Hospital",
            "address_purpose": "LOCATION",
            "city": "Wadena",
            "state": "MN",
            "postal_code": "564821296",
            "country_code": "US",
            "telephone_number": "218-631-3510",
            "fax_number": "218-631-7507",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KLOSS",
        "first_name": "DAVID",
        "middle_name": "A",
        "name_prefix": "Mr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-23",
        "last_updated": "2019-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "WI",
            "license": "68403",
            "primary": true
        },
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CT",
            "license": "033503",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MN",
            "license": "54709",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BC / BS",
            "identifier": "010033503CT01",
            "state": "CT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001335034",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA / US HEALTHCARE",
            "identifier": "0706347",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CARE FAMILY PLAN",
            "identifier": "001335034",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CONNECTICARE",
            "identifier": "335030",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "1144213006",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD",
            "identifier": "WIS020",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHNET",
            "identifier": "030515",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CHA",
            "identifier": "P02113",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Emmy Kiecker, OTR
• Joshua Kilmer
• King Psychological Services
• Cynthia Ellen Kirschling, OTR
• Julia R Kleuskens, DPT
• Nicole Jeannine Klotzbuecher, OD
• Amber R Knoll, PTA
• Amy Marie Kohel, LCSW
• Gary Komp, B.S.
• Elle Kosciuk, ATC

• Surgery Physician in Shawano, WI
• Providers in Shawano, WI by specialty
• Surgery Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.