Individual provider Active NPI

Michael Scott Kluska, DO

  • Plastic Surgery Physician
  • Commerce, GA
National Provider Identifier
1184621757
Registry record updated May 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic Surgery PhysicianTaxonomy code 208200000X
License
82763 Issued in GA
Practice address
30931 Highway 441 S
Commerce, GA 30529
Phone
(706) 335-3555
Fax
(706) 336-8122
NPI assigned
Jun 28, 2005
Last updated
May 21, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 21, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic Surgery Physician 208200000X OS010619L PA
Plastic Surgery Physician 208200000X 82763 GA Primary
Plastic and Reconstructive Surgery Physician 2086S0122X 82763 GA

Addresses

Primary practice location

30931 Highway 441 S
Commerce, GA 30529

Mailing address

30931 Highway 441 S
Commerce, GA 30529
Phone (706) 335-3555

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV
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
I20111122000344 WV Practitioner - General Surgery 5294726386 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
82763GAMDPlastic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Greenbrier Clinic Surgery Center Current Accepting new patients
Windber Hospital, Inc. Past Accepting new patients
Surgical Specialists of the Alleghenies Past Accepting new patients

Locations

40823 Midland Trl E
Wht Sphr Spgs, WV 24986
Phone (304) 536-4870

Interoperability endpoints

  • Direct secure messaging: mkluska@direct.excelahealth.org
  • Direct secure messaging: mkluska@directaddress.net

Organizations & group practices 4

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": "1119916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716249600000",
    "number": "1184621757",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30931 HIGHWAY 441 S",
            "city": "COMMERCE",
            "state": "GA",
            "postal_code": "30529",
            "telephone_number": "706-335-3555",
            "fax_number": "706-336-8122"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30931 HIGHWAY 441 S",
            "city": "COMMERCE",
            "state": "GA",
            "postal_code": "30529",
            "telephone_number": "706-335-3555",
            "fax_number": "706-336-8122"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLUSKA",
        "first_name": "MICHAEL",
        "middle_name": "SCOTT",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-06-28",
        "last_updated": "2024-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "PA",
            "license": "OS010619L",
            "primary": false
        },
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "GA",
            "license": "82763",
            "primary": true
        },
        {
            "code": "2086S0122X",
            "taxonomy_group": "",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": "GA",
            "license": "82763",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Commerce, GA

Sources for this page

Verify at the official NPI Registry.