Individual provider Active NPI

Daniel Robert Klemp, O.D.

  • Optometrist
  • Lewiston, ID
National Provider Identifier
1174513238
Registry record updated Aug 7, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
ODP897 Issued in ID
Practice address
1910 Idaho Street
Lewiston, ID 83501-2053
Phone
(208) 743-4022
Fax
(208) 746-0170
NPI assigned
Oct 28, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 7, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X ODP897 ID Primary

Addresses

Primary practice location

1910 Idaho Street
Lewiston, ID 83501-2053

Mailing address

1910 Idaho Street
Lewiston, ID 83501-2053
Phone (208) 743-4022

Other identifiers 6

IdentifierTypeStateIssuer
KLEDA5047950479OtherWAPREMERA
000010015581OtherIDREGENCE
000309000MedicaidID
V7167OtherIDBLUE CROSS OF IDAHO
2022739MedicaidWA
0133176OtherIDDEPT OF LABOR & INDUSTRY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060331000018 ID Practitioner - Optometry 0648288829 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 1992
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1910 Idaho St
Lewiston, ID 83501-2564
Phone (208) 743-4022

Merit-based Incentive Payment System (MIPS)

Final score
94.17 of 100Reported as individual
Quality
88.33
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery79

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
897IDMDMental Health Counselor
ODP897IDMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Klemp Optometry Optometrist CurrentSince Jan 1, 2006 Accepting new patients

Locations

1910 Idaho St
Lewiston, ID 83501
Phone (208) 743-4022

307 19th St
Ste A3
Lewiston, ID 83501
Phone (208) 743-4022

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1130457600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1344297600000",
    "number": "1174513238",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1910 IDAHO STREET",
            "city": "LEWISTON",
            "state": "ID",
            "postal_code": "835012053",
            "telephone_number": "208-743-4022",
            "fax_number": "208-746-0170"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1910 IDAHO STREET",
            "city": "LEWISTON",
            "state": "ID",
            "postal_code": "835012053",
            "telephone_number": "208-743-4022",
            "fax_number": "208-746-0170"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLEMP",
        "first_name": "DANIEL",
        "middle_name": "ROBERT",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-28",
        "last_updated": "2012-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "ID",
            "license": "ODP897",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREMERA",
            "identifier": "KLEDA5047950479",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE",
            "identifier": "000010015581",
            "state": "ID"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000309000",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS OF IDAHO",
            "identifier": "V7167",
            "state": "ID"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2022739",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEPT OF LABOR & INDUSTRY",
            "identifier": "0133176",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lewiston, ID

Sources for this page

Verify at the official NPI Registry.