NPIMap

Individual provider Active NPI

Michael R. Klieger, MD

  • Diagnostic Radiology Physician
  • Modesto, CA
National Provider Identifier
1114975588
Registry record updated Jan 27, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
A105793 Issued in CA
Practice address
1524 McHenry Ave
Suite 100
Modesto, CA 95350-4500
Phone
(209) 571-6622
Fax
(209) 527-2069
NPI assigned
May 5, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 27, 2009

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 043877 CT
Diagnostic Radiology Physician 2085R0202X A105793 CA Primary

Addresses

Primary practice location

1524 McHenry Ave
Suite 100
Modesto, CA 95350-4500

Mailing address

PO Box 30997
Los Angeles, CA 90030-0997
Phone (559) 455-4053

Other identifiers 1

IdentifierTypeStateIssuer
02571424MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090123000506 CA Practitioner - Diagnostic Radiology 9739163320 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
State University of Ny Upstate Medical University, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Turlock Imaging Services, LLCGroup PAC ID 3678850922, 16 clinicians

Practice addresses (Care Compare)

3900 Geer Rd
Turlock, CA 95382-1147
Phone (209) 669-0600

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
100
Improvement activities
40
Cost
84.14

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A105793CAMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Modesto Radiological Medical Group, Inc. Diagnostic Radiology CurrentSince Dec 1, 2009 Accepting new patients
Modesto Radiology Imaging, Inc. Diagnostic Radiology CurrentSince Apr 1, 2012 Accepting new patients
Turlock Imaging Services, LLC CurrentSince Apr 1, 2017 Accepting new patients
Putnam Imaging Associates PC Diagnostic Radiology Past Accepting new patients
Nyumc Radiology Associates Diagnostic Radiology Past Accepting new patients
New York University Medical Center Faculty Practice Radiology Diagnostic Radiology Past Accepting new patients

Locations

1524 McHenry Ave
Ste 100
Modesto, CA 95350
Phone (209) 571-6622

1524 McHenry Ave
Ste 430
Modesto, CA 95350
Phone (301) 676-5825

3900 Geer Rd
#1112
Turlock, CA 95382
Phone (209) 669-0600

3900 Geer Rd
Turlock, CA 95382
Phone (209) 669-0600

Organizations & group practices 6

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.

Hospital & facility affiliations 16

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1146787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1233014400000",
    "number": "1114975588",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 30997",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900300997",
            "telephone_number": "559-455-4053",
            "fax_number": "559-455-4007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1524 MCHENRY AVE",
            "address_2": "SUITE 100",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953504500",
            "telephone_number": "209-571-6622",
            "fax_number": "209-527-2069"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLIEGER",
        "first_name": "MICHAEL",
        "middle_name": "R.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-05",
        "last_updated": "2009-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "CT",
            "license": "043877",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "CA",
            "license": "A105793",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02571424",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Modesto, CA

Sources for this page

Verify at the official NPI Registry.