Thomas E Klootwyk, MD

Primary specialty

Sports Medicine (Orthopaedic Surgery) PhysicianTaxonomy code 207XX0005X

License

01040367A Issued in IN

Practice address

10767 Illinois St Ste 3000
Carmel, IN 46032-8972

Phone

(317) 817-1200

Fax

(317) 817-1220

NPI assigned

May 19, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in IN

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

Specialty

Orthopedic SurgeryAlso: Sports Medicine

Education

Indiana University School of Medicine, 1986

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Thomas a Brady Sports Medicine Center, PCGroup PAC ID 5991609281, 100 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: tklootwyk404301@direct.franciscanalliance.org

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.

• Thomas a Brady Sports Medicine Center, PC

  dba Forte Sports Medicine and Orthopedics

  • Orthopaedic Surgery Physician
  • Carmel, IN
  • NPI 1467484212

  Sports Medicine

  Medicare reassignment Care Compare group NPD
• Thomas a Brady Sports Medicine Center, PC

  dba Forte Sports Medicine and Orthopedics

  • Orthopaedic Surgery Physician
  • Noblesville, IN
  • NPI 1407480239

  Sports Medicine

  NPD
• Major Hospital

  • General Acute Care Hospital
  • Shelbyville, IN
  • NPI 1174555692
  NPD (past)
• Gibson Community Hospital Association

  dba Gibson Area Hospital and Health Services

  • Critical Access Hospital
  • Gibson City, IL
  • NPI 1114935681
  NPD (past)

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

{
    "created_epoch": "1147996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672704000000",
    "number": "1245284967",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10767 ILLINOIS ST STE 3000",
            "city": "CARMEL",
            "state": "IN",
            "postal_code": "460328972",
            "telephone_number": "317-817-1200",
            "fax_number": "317-817-1220"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10767 ILLINOIS ST STE 3000",
            "city": "CARMEL",
            "state": "IN",
            "postal_code": "460328972",
            "telephone_number": "317-817-1200",
            "fax_number": "317-817-1220"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLOOTWYK",
        "first_name": "THOMAS",
        "middle_name": "E",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-19",
        "last_updated": "2023-01-03",
        "certification_date": "2023-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207XX0005X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": "IN",
            "license": "01040367A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "200013393",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100461070A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kline Chiropractic
• Heidi Kline, DC
• Elizabeth Klisiewicz, BSN, RN
• Robert Gerald Klitzman, M.D.
• Amy S Klooster, PT
• Lynn R. Klus, M.D.
• Vicki Knapke, DC
• Peter M Knapp Jr., M.D.
• Kate E Kneifel, LCSW
• Kristin Kneisley

• Sports Medicine (Orthopaedic Surgery) Physician in Carmel, IN
• Providers in Carmel, IN by specialty
• Sports Medicine (Orthopaedic Surgery) Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.