Hayden Klockenga, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

070024984 Issued in IL

Practice address

4121 Veterans Memorial Dr
Mount Vernon, IL 62864-6262

Phone

(618) 242-3778

NPI assigned

Feb 27, 2020

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Orthopaedic Center of Southern Illinois, LTDGroup PAC ID 6901705441, 18 clinicians

Premise Health of Illinois Medical PCGroup PAC ID 3971764762, 26 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

79.43 of 100Reported as group

Quality

59.68

Promoting interoperability

92

Improvement activities

40

Cost

72.02

Medicare enrollment (NPD)

Enrolled

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 and National Provider Directory roles.

• Orthopaedic Center of Southern Illinois, LTD.

  • Orthopaedic Surgery Physician
  • Mount Vernon, IL
  • NPI 1134171226
  Medicare reassignment Care Compare group NPD
• Premise Health of Illinois Medical PC

  • Primary Care Clinic/Center
  • Mount Vernon, IL
  • NPI 1427366921
  Medicare reassignment Care Compare group NPD
• Orthopaedic Center of Southern Illinois, LTD.

  • Orthopaedic Surgery Physician
  • Centralia, IL
  • NPI 1932432143
  NPD
• Premise Health of Illinois Medical PC

  • Multi-Specialty Clinic/Center
  • Utica, IL
  • NPI 1295518868
  NPD

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

{
    "created_epoch": "1582761600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1582761600000",
    "number": "1073147161",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4121 VETERANS MEMORIAL DR",
            "city": "MOUNT VERNON",
            "state": "IL",
            "postal_code": "628646262",
            "telephone_number": "618-242-3778"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4121 VETERANS MEMORIAL DR",
            "city": "MOUNT VERNON",
            "state": "IL",
            "postal_code": "628646262",
            "telephone_number": "618-242-3778"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLOCKENGA",
        "first_name": "HAYDEN",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-02-27",
        "last_updated": "2020-02-27",
        "certification_date": "2020-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070024984",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Melissa Klausman, CNM, WHNP-BC
• Klein & Cook Orthodontics LLC
• Klein Orthodontics LLC
• Aaron Leonard Klein, M.D.
• Christopher Klein, DMD,M.S.
• Haylee Mae Dawn Knight, MHP
• Larry W Knopp, MA LCPC
• David R Knowles, MD
• Heather Diann Knowles, APN-BC ACNP
• Erika Knox, OTR

• Physical Therapist in Mount Vernon, IL
• Providers in Mount Vernon, IL by specialty
• Physical Therapist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.