Michael Klose

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

Practice address

7050 Air Depot Blvd
Tinker Afb, OK 73145-8716

Phone

(405) 734-2778

Fax

(405) 736-3128

NPI assigned

Nov 5, 2014

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in OK

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

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.

• Mercy Oklahoma Ambulatory Services LLC

  • Urgent Care Clinic/Center
  • Moore, OK
  • NPI 1922509173
  Medicare reassignment
• Summit Medical Center

  • General Acute Care Hospital
  • Edmond, OK
  • NPI 1356574560
  NPD (past)

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

{
    "created_epoch": "1415145600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728259200000",
    "number": "1053717975",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7050 AIR DEPOT BLVD",
            "city": "TINKER AFB",
            "state": "OK",
            "postal_code": "731458716",
            "telephone_number": "405-734-2778",
            "fax_number": "405-736-3128"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7050 AIR DEPOT BLVD",
            "city": "TINKER AFB",
            "state": "OK",
            "postal_code": "731458716",
            "telephone_number": "405-734-2778",
            "fax_number": "405-736-3128"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLOSE",
        "first_name": "MICHAEL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-11-05",
        "last_updated": "2024-10-07",
        "certification_date": "2024-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brandi Nicole Kelley, IDMT
• Stanley Jarman Kimball, D.O., MPH
• Edward Thomas King, M.D.
• Ray King, PSY.D.
• Timothy L. Kinzie, DO
• Wendi Lynn Knowles, R.D.
• Joel Jason Kraft, MD
• Ernest Castro Lee, M.D., M.P.H.
• Jeanne Ann Lewis, IDMT
• Carl Martin Lindquist, D.O.

• Medical Physician Assistant in Tinker Afb, OK
• Providers in Tinker Afb, OK by specialty
• Medical Physician Assistant in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2024; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.