Individual provider Active NPI

Vida HB Klott, MPAS, PAC

  • Physician Assistant
  • Lansing, MI
National Provider Identifier
1144326737
Registry record updated Oct 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
5601004563 Issued in MI
Practice address
6465 Millennium Ste 100
Lansing, MI 48917-7831
Phone
(517) 975-3720
Fax
(517) 323-7633
NPI assigned
Sep 15, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 17, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 5601004563 MI Primary

Addresses

Primary practice location

6465 Millennium Ste 100
Lansing, MI 48917-7831

Mailing address

6465 Millennium Ste 100
Lansing, MI 48917-7831
Phone (517) 975-3720

Other identifiers 2

IdentifierTypeStateIssuer
N77190003OtherMIMEDICARE PIN
0N77190OtherMIGROUP MEDICARE PIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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

Enrollment IDStateProvider typePAC IDDetails
I20051025000184 MI Practitioner - Physician Assistant 1052338597 Reassigns benefits to 7 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
McLaren Medical GroupGroup PAC ID 3971416082, 240 clinicians
Post Acute Medical PLLCGroup PAC ID 5193156115, 433 clinicians

Practice addresses (Care Compare)

12805 Escanaba Dr
Suite 1
Dewitt, MI 48820-8628
Phone (517) 913-3930

1500 Spring St
Petoskey, MI 49770-9295
Phone (888) 408-7008

401 S Ballenger Hwy
Flint, MI 48532-3638
Phone (810) 342-2000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
5601004563MIMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Vpa PC CurrentSince May 1, 2017 Accepting new patients
McLaren Medical Group CurrentSince Dec 2, 2024 Accepting new patients
Bosworth Urgent Care PC CurrentSince Dec 1, 2024 Accepting new patients
McLaren Greater Lansing Physician Assistant CurrentSince Aug 14, 2023 Accepting new patients
Wa Foote Memorial Hospital, Inc Physician Assistant CurrentSince Aug 27, 2010 Accepting new patients
W.a. Foote Memorial Hospital, Inc Physician Assistant CurrentSince Aug 27, 2010 Accepting new patients
McLaren Greater Lansing CurrentSince Aug 14, 2023 Accepting new patients
Vpa PC CurrentSince May 1, 2017 Accepting new patients
Exclusive Physicians PLLC Past Accepting new patients
Edward W Sparrow Hospital Association Past Accepting new patients

Locations

39373 Garfield Rd
Clinton Twp, MI 48038
Phone (586) 286-4880

12805 Escanaba Dr
Ste 2
Dewitt, MI 48820
Phone (517) 367-5520

21501 Kelly Rd
Eastpointe, MI 48021
Phone (586) 498-9200

401 S Ballenger Hwy
Flint, MI 48532
Phone (810) 342-1000

3499 S Linden Rd
Ste 2
Flint, MI 48507
Phone (810) 820-8121

205 N East Ave
Jackson, MI 49201
Phone (517) 788-4730

6465 Millennium
Ste 100
Lansing, MI 48917
Phone (517) 975-3720

130 N Sherman St
Leslie, MI 49251
Phone (517) 205-2500

2205 Jolly Rd
Ste B
Okemos, MI 48864
Phone (517) 347-4085

1881 W Grand River Ave
Okemos, MI 48864
Phone (517) 339-2100

500 Kirts Blvd
Ste 200
Troy, MI 48084
Phone (248) 824-6060

500 Kirts Blvd
Ste 100
Troy, MI 48084
Phone (214) 824-6000

Interoperability endpoints

  • Direct secure messaging: vida.klott.1@33060.direct.athenahealth.com

Organizations & group practices 15

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.

View all 15

Hospital & facility affiliations 3

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

NPI Registry JSON

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

{
    "created_epoch": "1158278400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697500800000",
    "number": "1144326737",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6465 MILLENNIUM STE 100",
            "city": "LANSING",
            "state": "MI",
            "postal_code": "489177831",
            "telephone_number": "517-975-3720",
            "fax_number": "517-323-7633"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6465 MILLENNIUM STE 100",
            "city": "LANSING",
            "state": "MI",
            "postal_code": "489177831",
            "telephone_number": "517-975-3720",
            "fax_number": "517-323-7633"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLOTT",
        "first_name": "VIDA",
        "middle_name": "HB",
        "name_prefix": "Mrs.",
        "credential": "MPAS, PAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-15",
        "last_updated": "2023-10-17",
        "certification_date": "2023-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601004563",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PIN",
            "identifier": "N77190003",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP MEDICARE PIN",
            "identifier": "0N77190",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lansing, MI

Sources for this page

Verify at the official NPI Registry.