Individual provider Active NPI

John Erasmus Klibanoff, MD

  • Orthopaedic Surgery Physician
  • Auburn, NY
National Provider Identifier
1255391652
Registry record updated Apr 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
198309 Issued in NY
Practice address
77 Nelson St
Ste 120
Auburn, NY 13021-1941
Phone
(315) 252-7559
Fax
(315) 253-8104
NPI assigned
Mar 28, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 3, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X 198309 NY Primary

Addresses

Primary practice location

77 Nelson St
Ste 120
Auburn, NY 13021-1941

Mailing address

17 Langsing St
Auburn, NY 13021-1983
Phone (315) 255-7011

Other practice location 1

360 Linden Oaks Ste 100
Rochester, NY 14625-2814
Phone (585) 723-2845

Other identifiers 2

IdentifierTypeStateIssuer
200026915OtherNYRR MEDICARE
01565719MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20050804000972 NY Practitioner - Orthopedic SurgeryPractitioner - Sports Medicine 8123057619 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
96.62 of 100Reported as apm
Quality
74.51
Promoting interoperability
100
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
75.68 of 100Reported as group
Quality
48.88
Promoting interoperability
91
Improvement activities
40
Cost
71.94

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Auburn Community Hospital CurrentSince Apr 1, 2024 Accepting new patients
Auburn Community Hospital CurrentSince Apr 1, 2024 Accepting new patients
Auburn Memorial Medical Services, PC Orthopaedic Surgery CurrentSince Apr 1, 2024 Accepting new patients
Rochester General Hospital Orthopaedic Surgery CurrentSince Mar 1, 2019 Accepting new patients
Auburn Memorial Medical Services, PC Orthopaedic Surgery CurrentSince Apr 1, 2024 Accepting new patients
Western New York Medical Practice P.C. CurrentSince Mar 1, 2019 Accepting new patients
Rochester General Hospital Orthopaedic Surgery CurrentSince Mar 1, 2019 Accepting new patients

Locations

77 Nelson St
Ste 120
Auburn, NY 13021
Phone (315) 252-7550

2410 Ridgeway Ave
Rochester, NY 14626
Phone (585) 225-7150

1425 Portland Ave
Rochester, NY 14621
Phone (585) 922-3122

100 Kings Hwy S
Rochester, NY 14617
Phone (585) 922-0553

360 Linden Oaks
Ste 100
Rochester, NY 14625
Phone (585) 723-2845

17 Lansing St
Sennett, NY 13021
Phone (315) 255-7011

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1143504000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712102400000",
    "number": "1255391652",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17 LANGSING ST",
            "city": "AUBURN",
            "state": "NY",
            "postal_code": "130211983",
            "telephone_number": "315-255-7011",
            "fax_number": "315-255-7099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "77 NELSON ST",
            "address_2": "STE 120",
            "city": "AUBURN",
            "state": "NY",
            "postal_code": "130211941",
            "telephone_number": "315-252-7559",
            "fax_number": "315-253-8104"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "360 Linden Oaks Ste 100",
            "address_purpose": "LOCATION",
            "city": "Rochester",
            "state": "NY",
            "postal_code": "146252814",
            "country_code": "US",
            "telephone_number": "585-723-2845",
            "fax_number": "585-723-6877",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KLIBANOFF",
        "first_name": "JOHN",
        "middle_name": "ERASMUS",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-28",
        "last_updated": "2024-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "NY",
            "license": "198309",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "200026915",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01565719",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Auburn, NY

Sources for this page

Verify at the official NPI Registry.