Individual provider Active NPI

Benjamin Klug, DO

  • Obstetrics & Gynecology Physician
  • North Platte, NE
National Provider Identifier
1265793137
Registry record updated May 8, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
1468 Issued in NE
Practice address
1115 S Willow St
North Platte, NE 69101-6082
Phone
(308) 534-4804
Fax
(308) 534-0460
NPI assigned
Jun 6, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 8, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 1468 NE Primary

Addresses

Primary practice location

1115 S Willow St
North Platte, NE 69101-6082

Mailing address

1115 S Willow St
North Platte, NE 69101-6082
Phone (308) 534-4804

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE
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
I20160627001158 NE Practitioner - Obstetrics/Gynecology 0042466492 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Platte OB/GYN PCGroup PAC ID 8820088701, 7 clinicians

Practice addresses (Care Compare)

1115 S Willow St
North Platte, NE 69101-6082
Phone (308) 534-4804

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Removal of the uterus1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1468NEMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
North Platte OB/GYN PC Obstetrics & Gynecology CurrentSince Jul 25, 2016 Accepting new patients
North Platte Nebraska Hospital Corporation Past Accepting new patients

Locations

1115 S Willow St
North Platte, NE 69101
Phone (308) 532-4700

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 and National Provider Directory roles.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1338940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1494201600000",
    "number": "1265793137",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1115 S WILLOW ST",
            "city": "NORTH PLATTE",
            "state": "NE",
            "postal_code": "691016082",
            "telephone_number": "308-534-4804"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1115 S WILLOW ST",
            "city": "NORTH PLATTE",
            "state": "NE",
            "postal_code": "691016082",
            "telephone_number": "308-534-4804",
            "fax_number": "308-534-0460"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLUG",
        "first_name": "BENJAMIN",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-06-06",
        "last_updated": "2017-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NE",
            "license": "1468",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Platte, NE

Sources for this page

Verify at the official NPI Registry.