Individual provider Active NPI

Seth Klusewitz

  • Cardiovascular Disease Physician
  • Fort Bliss, TX
National Provider Identifier
1306290507
Registry record updated Aug 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
0101264896 Issued in VA
Practice address
18511 Highlander Medics St
Fort Bliss, TX 79906-5327
Phone
(915) 742-7777
NPI assigned
Apr 14, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 7, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Cardiovascular Disease Physician 207RC0000X 0101264896 VA Primary

Addresses

Primary practice location

18511 Highlander Medics St
Fort Bliss, TX 79906-5327

Mailing address

18511 Highlander Medics St
Fort Bliss, TX 79906-5327
Phone (915) 742-7777

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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
I20200518003059 VA Order and Referring Only - Internal MedicinePractitioner - Internal Medicine 4082045406

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0101264896VAMDCardiovascular Disease Physician

NPI Registry JSON

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

{
    "created_epoch": "1460592000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691366400000",
    "number": "1306290507",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18511 HIGHLANDER MEDICS ST",
            "city": "FORT BLISS",
            "state": "TX",
            "postal_code": "799065327",
            "telephone_number": "915-742-7777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18511 HIGHLANDER MEDICS ST",
            "city": "FORT BLISS",
            "state": "TX",
            "postal_code": "799065327",
            "telephone_number": "915-742-7777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLUSEWITZ",
        "first_name": "SETH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-04-14",
        "last_updated": "2023-08-07",
        "certification_date": "2023-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "VA",
            "license": "0101264896",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Bliss, TX

Sources for this page

Verify at the official NPI Registry.