Individual provider Active NPI

Kayleigh Emma Krogh Clark Klose, MD, MBA

  • Pediatric Hematology & Oncology Physician
  • Valhalla, NY
National Provider Identifier
1144757501
Registry record updated May 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Hematology & Oncology PhysicianTaxonomy code 2080P0207X
License
304579 Issued in NY
Practice address
100 Woods Rd
Valhalla, NY 10595-1530
Phone
(914) 493-7000
NPI assigned
May 16, 2017
Last updated
May 8, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 8, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 304579 NY
Pediatric Hematology & Oncology Physician 2080P0207X 304579 NY Primary

Addresses

Primary practice location

100 Woods Rd
Valhalla, NY 10595-1530

Mailing address

19 Bradhurst Ave Ste 800S
Hawthorne, NY 10532-2140

Other practice location 1

19 Bradhurst Ave Ste 800S
Hawthorne, NY 10532-2140
Phone (914) 614-4270

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240806000874 NY Practitioner - Pediatric Medicine 2062959232 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pediatric Medicine
Education
Albany Medical College of Union University, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Boston Children's Health Physicians LLPGroup PAC ID 8325937014, 80 clinicians

Practice addresses (Care Compare)

19 Bradhurst Ave
Suite 800
Hawthorne, NY 10532-2198
Phone (914) 493-8558

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Business Administration, Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Boston Children's Health Physicians, LLP Pediatrics CurrentSince Jul 1, 2024 Accepting new patients
Boston Childrens Health Physicians LLP CurrentSince Jul 1, 2024 Accepting new patients
Westchester County Health Care Corporation Past Accepting new patients

Locations

19 Bradhurst Ave
Hawthorne, NY 10532
Phone (914) 493-7235

19 Bradhurst Ave
Ste 800
Hawthorne, NY 10532
Phone (914) 493-7583

19 Bradhurst Ave
Ste 800S
Hawthorne, NY 10532
Phone (914) 614-4270

100 Woods Rd
Valhalla, NY 10595
Phone (914) 490-7000

400 Columbus Ave
Ste 200E
Valhalla, NY 10595
Phone (914) 490-0401

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H3359

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
  • Direct secure messaging: kayleigh.klose.p1@direct.cwpw.nextgenshare.com

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

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": "1494892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715126400000",
    "number": "1144757501",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19 BRADHURST AVE STE 800S",
            "city": "HAWTHORNE",
            "state": "NY",
            "postal_code": "105322140"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 WOODS RD",
            "city": "VALHALLA",
            "state": "NY",
            "postal_code": "105951530",
            "telephone_number": "914-493-7000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "19 Bradhurst Ave Ste 800S",
            "address_purpose": "LOCATION",
            "city": "Hawthorne",
            "state": "NY",
            "postal_code": "105322140",
            "country_code": "US",
            "telephone_number": "914-614-4270",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KLOSE",
        "first_name": "KAYLEIGH",
        "middle_name": "EMMA KROGH CLARK",
        "credential": "MD, MBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-05-16",
        "last_updated": "2024-05-08",
        "certification_date": "2024-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "304579",
            "primary": false
        },
        {
            "code": "2080P0207X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Hematology-Oncology",
            "state": "NY",
            "license": "304579",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Valhalla, NY

Sources for this page

Verify at the official NPI Registry.