Mark Ellsworth Kleinman, M.D.

Primary specialty

Retina Specialist (Ophthalmology) PhysicianTaxonomy code 207WX0107X

License

44136 Issued in KY

Practice address

2412 N John B Dennis Hwy
Kingsport, TN 37660-4772

Phone

(423) 578-4364

Fax

(423) 578-4372

NPI assigned

Jul 16, 2008

Last updated

Nov 4, 2025By 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 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in KY, TN, VA3 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 3

Specialty

Ophthalmology

Education

New York University School of Medicine, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Southeastern Retina Associates PCGroup PAC ID 7517862360, shared by 2 NPIs, 21 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

90.61 of 100Reported as group

Quality

86.74

Promoting interoperability

93

Improvement activities

40

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Southeastern Retina Associates, P.C.

  • Retina Specialist (Ophthalmology) Physician
  • Hixson, TN
  • NPI 1104097310
  Medicare reassignment NPD
• Southeastern Retina Associates, P.C.

  • Retina Specialist (Ophthalmology) Physician
  • Knoxville, TN
  • NPI 1932200664

  VA

  Medicare reassignment NPD
• Kentucky Medical Services Foundation, Inc

  • Internal Medicine Physician
  • Lexington, KY
  • NPI 1326091448

  Ophthalmology

  Medicare reassignment NPD
• Southeastern Retina Associates, P.C.

  • Retina Specialist (Ophthalmology) Physician
  • Kingsport, TN
  • NPI 1932370145
  NPD
• University of Kentucky

  • Diagnostic Radiology Physician
  • Lexington, KY
  • NPI 1770771974
  NPD (past)

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

{
    "created_epoch": "1216166400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762214400000",
    "number": "1063676310",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "320 PROSPERITY DR",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379234709",
            "telephone_number": "423-756-1512"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2412 N JOHN B DENNIS HWY",
            "city": "KINGSPORT",
            "state": "TN",
            "postal_code": "376604772",
            "telephone_number": "423-578-4364",
            "fax_number": "423-578-4372"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLEINMAN",
        "first_name": "MARK",
        "middle_name": "ELLSWORTH",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-07-16",
        "last_updated": "2025-11-04",
        "certification_date": "2025-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "KY",
            "license": "44136",
            "primary": false
        },
        {
            "code": "207WX0107X",
            "taxonomy_group": "",
            "desc": "Ophthalmology, Retina Specialist",
            "state": "KY",
            "license": "44136",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100169870",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Heather L Kistner, M.S., CCC-A
• Peter John Kitching, OT
• Amy F Kite, PA, ASCP (CM)
• Elizabeth Anne Kitzmiller, PH.D., LPC-MHSP,LMFT
• Jeffery Klein
• John F Kliesch, MD
• Lori Klinger, PH.D.
• Cory Scott Knecht, MD
• Cynthia L Knecht, CRNA
• Maureen A Knechtel, PA

• Retina Specialist (Ophthalmology) Physician in Kingsport, TN
• Providers in Kingsport, TN by specialty
• Retina Specialist (Ophthalmology) Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2025; 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.