Individual provider Active NPI

Dale A Klein, MD

  • Family Medicine Physician
  • Mandan, ND
National Provider Identifier
1215048277
Registry record updated Sep 11, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
4894 Issued in ND
Practice address
910 18TH St NW
Mandan, ND 58554-1612
Phone
(701) 667-5100
Fax
(701) 323-5709
NPI assigned
Aug 31, 2006
Last updated
Sep 11, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 4894 ND Primary

Addresses

Primary practice location

910 18TH St NW
Mandan, ND 58554-1612

Mailing address

PO Box 5501
Bismarck, ND 58506-5501
Phone (701) 323-6000

Other identifiers 1

IdentifierTypeStateIssuer
14310MedicaidND

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
89.63 of 100Reported as group
Quality
89.39
Promoting interoperability
100
Improvement activities
40
Cost
76.04

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4894NDMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Sanford Bismarck Current Accepting new patients
Medcenter One Health Systems DME Current Accepting new patients

Organizations & group practices 2

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": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1189468800000",
    "number": "1215048277",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5501",
            "city": "BISMARCK",
            "state": "ND",
            "postal_code": "585065501",
            "telephone_number": "701-323-6000",
            "fax_number": "701-323-5709"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "910 18TH ST NW",
            "city": "MANDAN",
            "state": "ND",
            "postal_code": "585541612",
            "telephone_number": "701-667-5100",
            "fax_number": "701-323-5709"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLEIN",
        "first_name": "DALE",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-31",
        "last_updated": "2007-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "ND",
            "license": "4894",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "14310",
            "state": "ND"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mandan, ND

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.