Active NPI
Mark Alan Klaas, M.D.
- Pulmonary Disease Physician
- Waukesha, WI
National Provider Identifier
1215994298
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pulmonary Disease Physician
- License
- 31805
- Practice address
- 725 American Ave
Waukesha, WI 53188-5031 - Phone
- (262) 928-2391
- Fax
- (262) 928-2718
- NPI assigned
- Apr 26, 2006
- Last updated
- Nov 20, 2009
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 31805 | WI | |
| Critical Care Medicine (Internal Medicine) Physician | 207RC0200X | 31805 | WI | |
| Pulmonary Disease Physician | 207RP1001X | 31805 | WI | Primary |
Addresses
Primary practice location
725 American Ave
Waukesha, WI 53188-5031
Mailing address
South 36 West 35541 Hwy D
Dousman, WI 53118
Phone (262) 965-5531
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 31797100 | Medicaid | WI |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 31805 | WI | MD | Critical Care Medicine (Internal Medicine) Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Prohealth Medical Group Inc | Internal Medicine | Past | Accepting new patients |
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": "1146009600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1258675200000",
"number": "1215994298",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "SOUTH 36 WEST 35541 HWY D",
"city": "DOUSMAN",
"state": "WI",
"postal_code": "53118",
"telephone_number": "262-965-5531"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "725 AMERICAN AVE",
"city": "WAUKESHA",
"state": "WI",
"postal_code": "531885031",
"telephone_number": "262-928-2391",
"fax_number": "262-928-2718"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KLAAS",
"first_name": "MARK",
"middle_name": "ALAN",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-04-26",
"last_updated": "2009-11-20",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "WI",
"license": "31805",
"primary": false
},
{
"code": "207RC0200X",
"taxonomy_group": "",
"desc": "Internal Medicine, Critical Care Medicine",
"state": "WI",
"license": "31805",
"primary": false
},
{
"code": "207RP1001X",
"taxonomy_group": "",
"desc": "Internal Medicine, Pulmonary Disease",
"state": "WI",
"license": "31805",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "31797100",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Waukesha, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.