John F Kludt, OD
Individual provider Active NPI Optometrist · Hettinger, ND
NPI 1053404756 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1053404756
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Optometrist 152W00000X
- License
- 0504 (ND)
- Practice address
- 1000 Highway 12
Hettinger, ND 58639 - Phone
- (701) 567-6133
- NPI assigned
- Oct 2, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 10
Hospital & facility affiliations 2
Medicare Care Compare profile
- Specialty
- Optometry
- Education
- Pacific University - College of Optometry, 1991
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- West River Health Services
Practice addresses (Care Compare)
1000 Hwy 12
Hettinger, ND 58639-7530
Phone (701) 567-4561
Hospital & facility affiliations
- West River Regional Medical Center
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Cataract surgery | 51 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in ND
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20050901000951 | ND | Practitioner - Optometry | 4082646799 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0504 | ND | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| West River Health Services | Current |
Accepting new patients | |
| West River Health Services | Current | Accepting new patients | |
| West River Health Services | Optometrist | Current |
Accepting new patients |
| West River Health Services | Past | Accepting new patients |
Locations
1100 Highway 12
Hettinger, ND 58639
Phone (701) 567-4561
1000 Highway 12
Hettinger, ND 58639
Phone (701) 567-4561
Interoperability endpoints
- johnkludt@wrhs.allscriptsdirect.net
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 0504 | ND | Yes |
Addresses
Primary practice location
1000 Highway 12
Hettinger, ND 58639
Mailing address
1100 Highway 12
Hettinger, ND 58639-7533
Phone (701) 567-6130
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 11201 | Other | ND BC/BS | |
| 9202430 | Medicaid | SD | |
| 480545 | Medicaid | MT | |
| 800504 | Other | ND BC VISION | |
| 60435 | Medicaid | ND |
Other providers in Hettinger, ND
- Ellen L Ketterling
- Steven C Kilwein
- Jacqueline Kling
- Lesley D Kling
- Isaiah Kludt
- Mark S Kristy
- Lantis Enterprises, Inc
- Charlotte Lee
- Paula C Lewis
- Jodi Lindquist
All providers in Hettinger, ND · Optometrist in North Dakota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.