Mark R Klocke, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

182253 Issued in NY

Practice address

6000 N Bailey Ave
Amherst, NY 14226-5102

Phone

(716) 834-4522

Fax

(716) 834-6191

NPI assigned

Oct 24, 2005

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

Other identifiers 6

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Interoperability endpoints

• Direct secure messaging: drklocke@allentownpediatrics.medentdirect.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.

• Allentown Pediatric and Adolescent Medicine

  • Pediatric Adolescent Medicine Physician
  • Buffalo, NY
  • NPI 1598729808
  NPD (past)

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

{
    "created_epoch": "1130112000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1405900800000",
    "number": "1104816065",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6000 N BAILEY AVE",
            "city": "AMHERST",
            "state": "NY",
            "postal_code": "142265102",
            "telephone_number": "716-834-4522",
            "fax_number": "716-834-6191"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6000 N BAILEY AVE",
            "city": "AMHERST",
            "state": "NY",
            "postal_code": "142265102",
            "telephone_number": "716-834-4522",
            "fax_number": "716-834-6191"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLOCKE",
        "first_name": "MARK",
        "middle_name": "R",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-24",
        "last_updated": "2014-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "182253",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIDELIS",
            "identifier": "040426001490",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNIVERA",
            "identifier": "00010092105",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01245578",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS",
            "identifier": "000511134005",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IHA",
            "identifier": "1208952",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERRED CARE",
            "identifier": "143849DL",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Bridget Klein
• Linda Karoline Kleine
• Lucas Klimek, DPT
• Dale Owen Klipfel, D.D.S.
• Marie Lynn Klocke, MSOTR/L
• Vicki Madaus Knapp, PH.D., BCBA
• Emily Knight
• Shelby Knoeller, MS, ATC
• Karen Lee Koch
• Richard Kenneth Koepke, M.S., M.DIV

• Pediatrics Physician in Amherst, NY
• Providers in Amherst, NY by specialty
• Pediatrics Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.