NPIMap

Individual provider Active NPI

Evelyn A. Kluka, MD

  • Pediatric Otolaryngology Physician
  • Pensacola, FL
National Provider Identifier
1306867320
Registry record updated Jun 21, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Otolaryngology PhysicianTaxonomy code 207YP0228X
License
ME113095 Issued in FL
Practice address
5153 North 9TH Ave.
Nemours Children'S Clinic, Pensacola
Pensacola, FL 32504-8785
Phone
(850) 505-4700
Fax
(850) 505-4714
NPI assigned
Jul 23, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 21, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 17700 LA
Pediatric Otolaryngology Physician 207YP0228X ME113095 FL Primary

Addresses

Primary practice location

5153 North 9TH Ave.
Nemours Children'S Clinic, Pensacola
Pensacola, FL 32504-8785

Mailing address

P.O. Box 191
Provider Enrollment Department
Rockland, DE 19732-0191
Phone (407) 650-7129

Other identifiers 1

IdentifierTypeStateIssuer
1385808MedicaidLA

Other names 1

  • Evelyn Kluka Meier Other name

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

LicenseStateTypeSpecialty
17700LAMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Children'S Hospital Past Accepting new patients
Louisiana State University School of Med in New Orleans Faculty Grou Past Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1153612800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1340236800000",
    "number": "1306867320",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 191",
            "address_2": "PROVIDER ENROLLMENT DEPARTMENT",
            "city": "ROCKLAND",
            "state": "DE",
            "postal_code": "197320191",
            "telephone_number": "407-650-7129",
            "fax_number": "302-651-4945"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5153 NORTH 9TH AVE.",
            "address_2": "NEMOURS CHILDREN'S CLINIC, PENSACOLA",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325048785",
            "telephone_number": "850-505-4700",
            "fax_number": "850-505-4714"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLUKA",
        "first_name": "EVELYN",
        "middle_name": "A.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-23",
        "last_updated": "2012-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "LA",
            "license": "17700",
            "primary": false
        },
        {
            "code": "207YP0228X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Pediatric Otolaryngology",
            "state": "FL",
            "license": "ME113095",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1385808",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "EVELYN",
            "last_name": "MEIER",
            "middle_name": "KLUKA",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Pensacola, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.