Organization Active NPI

Steven Klecker

  • Optometrist
  • Lexington, KY
National Provider Identifier
1336317080
Registry record updated Dec 10, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
KY844DT Issued in KY
Legal business name
STEVEN KLECKER
Practice address
1555 E New Circle Rd Ste 146
Lexington, KY 40509-1044
Phone
(859) 269-6921
Fax
(859) 266-9504
NPI assigned
Feb 15, 2008
Organization subpart
Yes
Parent organization
STEVEN KLECKERAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 10, 2014

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

Authorized official

Name
Steven Ambrose Klecker, O.D.NPI 1821098401
Title
Owner
Phone
(859) 269-6921

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X KY844DT KY Primary

Addresses

Primary practice location

1555 E New Circle Rd Ste 146
Lexington, KY 40509-1044

Mailing address

1555 E New Circle Rd Ste 146
Lexington, KY 40509-1044
Phone (859) 269-6921

Other identifiers 2

IdentifierTypeStateIssuer
77008449MedicaidKY
9836OtherMEDICARE GROUP ID

Other names 1

  • STEVEN KLECKER OPTOMETRIST Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20051018000642 KY Part B Supplier - Clinic/Group Practice 7719903871 Receives reassigned benefits from 2 practitioners
Practice locations: Lexington, KY

National Provider Directory

National Provider Directory
Part of
Steven Klecker

Locations

1555 E New Circle Rd
Ste 146
Lexington, KY 40509
Phone (859) 266-3003

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1203033600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1418169600000",
    "number": "1336317080",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1555 E NEW CIRCLE RD STE 146",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405091044",
            "telephone_number": "859-269-6921",
            "fax_number": "859-266-9504"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1555 E NEW CIRCLE RD STE 146",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405091044",
            "telephone_number": "859-269-6921",
            "fax_number": "859-266-9504"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STEVEN KLECKER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "STEVEN KLECKER",
        "enumeration_date": "2008-02-15",
        "last_updated": "2014-12-10",
        "status": "A",
        "authorized_official_last_name": "KLECKER",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_middle_name": "AMBROSE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "859-269-6921",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "KY",
            "license": "KY844DT",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "77008449",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP ID",
            "identifier": "9836",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "STEVEN KLECKER OPTOMETRIST",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Lexington, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.