Individual provider Active NPI

Michael Eugene Klaich, O.D.

  • Optometrist
  • Grand Junction, CO
National Provider Identifier
1073556577
Registry record updated Dec 16, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1314 Issued in CO
Practice address
1306 E Sherwood Dr
Grand Junction, CO 81501-7578
Phone
(970) 245-5678
Fax
(970) 245-5679
NPI assigned
Jun 13, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 16, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 1314 CO Primary

Addresses

Primary practice location

1306 E Sherwood Dr
Grand Junction, CO 81501-7578

Mailing address

1306 E Sherwood Dr
Grand Junction, CO 81501-7578
Phone (970) 245-5678

Other identifiers 1

IdentifierTypeStateIssuer
08131492MedicaidCO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090318000520 CO Practitioner - Optometry 4587721584 Receives reassigned benefits from 1 practitioner
Practice locations: Grand Junction, CO

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern California College of Optometry, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1306 E Sherwood Dr
Grand Junction, CO 81501-7578
Phone (970) 245-5678

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery57

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1314COMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Michael E. Klaich, O.D. Optometrist PastSince Mar 1, 2004 Accepting new patients

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1150156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1260921600000",
    "number": "1073556577",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1306 E SHERWOOD DR",
            "city": "GRAND JUNCTION",
            "state": "CO",
            "postal_code": "815017578",
            "telephone_number": "970-245-5678",
            "fax_number": "970-245-5679"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1306 E SHERWOOD DR",
            "city": "GRAND JUNCTION",
            "state": "CO",
            "postal_code": "815017578",
            "telephone_number": "970-245-5678",
            "fax_number": "970-245-5679"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLAICH",
        "first_name": "MICHAEL",
        "middle_name": "EUGENE",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-13",
        "last_updated": "2009-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CO",
            "license": "1314",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "08131492",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Junction, CO

Sources for this page

Verify at the official NPI Registry.