Individual provider Active NPI

Jason J Klovning, M.D.

  • Surgery Physician
  • Rockford, IL
National Provider Identifier
1366612012
Registry record updated Mar 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
036-141917 Issued in IL
Practice address
1340 Charles St Ste 100
Rockford, IL 61104-2200
Phone
(779) 696-8700
Fax
(779) 696-8745
NPI assigned
Mar 10, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 1, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 026609 LA
Surgery Physician 208600000X 55772 WI
Surgery Physician 208600000X 036-141917 IL Primary

Addresses

Primary practice location

1340 Charles St Ste 100
Rockford, IL 61104-2200

Mailing address

PO Box 78866
Milwaukee, WI 53278-8866
Phone (779) 696-7150

Other practice location 1

1450 Eastside Rd
Ste 110
Platteville, WI 53818-9800
Phone (608) 348-4330

Other identifiers 2

IdentifierTypeStateIssuer
61243OtherWIDEAN HEALTH PLAN
100017464MedicaidWI

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jklovningmd911697@direct.uwhealth.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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
I20170103000928 IL Practitioner - General Surgery 0042382160 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
University of Wisconsin School of Medicine, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Swedishamerican HospitalGroup PAC ID 5799698346, 386 clinicians

Practice addresses (Care Compare)

1401 E State St
Rockford, IL 61104-2315
Phone (815) 489-4400

209 9TH St
Suite 200
Rockford, IL 61104-2235
Phone (779) 696-2750

6824 Newburg Rd
Sa Valley
Rockford, IL 61108-4330
Phone (779) 696-7610

Hospital & facility affiliations

  • Uw Health Hospital, Rockford, IL, CCN 140228

Merit-based Incentive Payment System (MIPS)

Final score
81.51 of 100Reported as group
Quality
83.2
Promoting interoperability
77
Improvement activities
40
Cost
71.7

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hernia repair - groin (open)1-10
Hernia repair (minimally invasive)1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036-141917ILMDSurgery Physician
026609LAMDSurgery Physician
55772WIMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Swedishamerican Hospital Current Accepting new patients
Swedishamerican Hospital Surgery CurrentSince Dec 24, 2016 Accepting new patients
Swedishamerican Hospital CurrentSince Dec 24, 2016 Accepting new patients
Dean Health Systems, Inc, Past Accepting new patients
Gwinnett Clinic LTD Past Accepting new patients

Locations

2550 Charles St
Rockford, IL 61108
Phone (779) 696-7285

1340 Charles St
Ste 100
Rockford, IL 61104
Phone (779) 696-1900

6824 Newburg Rd
Rockford, IL 61108
Phone (779) 696-7610

Interoperability endpoints

  • Direct secure messaging: jklovningmd911697@direct.uwhealth.org
  • Direct secure messaging: nsullivan1046195@direct.uwhealth.org

Organizations & group practices 5

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 1

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": "1205107200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614556800000",
    "number": "1366612012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 78866",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532788866",
            "telephone_number": "779-696-7150"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1340 CHARLES ST STE 100",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611042200",
            "telephone_number": "779-696-8700",
            "fax_number": "779-696-8745"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1450 Eastside Rd",
            "address_2": "Ste 110",
            "address_purpose": "LOCATION",
            "city": "Platteville",
            "state": "WI",
            "postal_code": "538189800",
            "country_code": "US",
            "telephone_number": "608-348-4330",
            "fax_number": "608-342-4801",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KLOVNING",
        "first_name": "JASON",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-03-10",
        "last_updated": "2021-03-01",
        "certification_date": "2021-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "LA",
            "license": "026609",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "WI",
            "license": "55772",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "IL",
            "license": "036-141917",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEAN HEALTH PLAN",
            "identifier": "61243",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100017464",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jklovningmd911697@direct.uwhealth.org",
            "affiliation": "N",
            "address_1": "1340 Charles St Ste 100",
            "city": "Rockford",
            "state": "IL",
            "country_code": "US",
            "postal_code": "611042200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Rockford, IL

Sources for this page

Verify at the official NPI Registry.