Daniel Klin

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

3336 Issued in CT

Practice address

114 Woodland St
Department of Medicine
Hartford, CT 06105-1208

Phone

(860) 714-5237

Fax

(860) 714-8097

NPI assigned

Jul 30, 2015

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 CT

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

Telehealth

Offers telehealth services

Group practices

Connecticut Behavioral Health Assoc PCGroup PAC ID 4385532373, 38 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: daniel.klin.1@32885.direct.athenahealth.com

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.

• Connecticut Behavioral Health Assoc, P.C.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • New London, CT
  • NPI 1629158126
  Medicare reassignment Care Compare group
• Trinity Health of New England Provider Network Organization Inc

  • Internal Medicine Physician
  • Waterville, ME
  • NPI 1134779531
  NPD (past)

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

{
    "created_epoch": "1438214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1446163200000",
    "number": "1104202241",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "114 WOODLAND ST",
            "address_2": "DEPARTMENT OF MEDICINE",
            "city": "HARTFORD",
            "state": "CT",
            "postal_code": "061051208",
            "telephone_number": "860-714-5237",
            "fax_number": "860-714-8097"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "114 WOODLAND ST",
            "address_2": "DEPARTMENT OF MEDICINE",
            "city": "HARTFORD",
            "state": "CT",
            "postal_code": "061051208",
            "telephone_number": "860-714-5237",
            "fax_number": "860-714-8097"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLIN",
        "first_name": "DANIEL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-07-30",
        "last_updated": "2015-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CT",
            "license": "3336",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "CT",
            "license": "3336",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jeffrey Alan Kleinberg, MD
• Kathryn M Klem, PA-C
• Elisa Klepacki, LPC
• Lucretia Klieback, LCSW
• Joseph J Klimek, M.D.
• Klingberg Comprehensive Family Services Inc
• Klingberg Family Centers Inc
• Vanessa Close Klopfer, PA-C
• Bohdan Klotska
• Abigail Leigh Kluczewski, PA-C

• Surgical Physician Assistant in Hartford, CT
• Providers in Hartford, CT by specialty
• Surgical Physician Assistant in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2015; 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.