Todd Robert Klesert, M.D., PH.D.

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

MD 60125691 Issued in WA

Practice address

1750 112TH Ave NE
Suite D050
Bellevue, WA 98004-3752

Phone

(206) 215-3850

Fax

(206) 215-3870

NPI assigned

Dec 15, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WA

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

Specialty

Ophthalmology

Education

University of Washington School of Medicine, 2001

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Pacific Northwest Retina PLLCGroup PAC ID 8820494073, 19 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine, Doctor of Philosophy

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
• Direct secure messaging: todd.klesert.p16@direct.pnwr.nextgenshare.com
• Direct secure messaging: todd.klesert.p16@direct.proliance.nextgenshare.com

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.

• Pacific Northwest Retina PLLC

  • Retina Specialist (Ophthalmology) Physician
  • Bellevue, WA
  • NPI 1558940387
  Medicare reassignment Care Compare group NPD
• Proliance Surgeons Inc P S

  • Orthopaedic Surgery Physician
  • Seattle, WA
  • NPI 1023170313
  Medicare reassignment NPD
• Proliance Surgeons Inc P S

  • Orthopaedic Surgery Physician
  • Renton, WA
  • NPI 1235091463
  NPD
• Proliance Surgeons, Inc., P.S.

  • Ophthalmology Physician
  • Tacoma, WA
  • NPI 1952835035
  NPD
• The Retina Surgery Center LLC

  • Ambulatory Surgical Clinic/Center
  • Bellevue, WA
  • NPI 1457670648
  NPD

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

{
    "created_epoch": "1166140800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692576000000",
    "number": "1386706174",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22232 17TH AVE SE STE 308",
            "city": "BOTHELL",
            "state": "WA",
            "postal_code": "980217425",
            "telephone_number": "425-296-3837",
            "fax_number": "206-215-3870"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1750 112TH AVE NE",
            "address_2": "SUITE D050",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980043752",
            "telephone_number": "206-215-3850",
            "fax_number": "206-215-3870"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLESERT",
        "first_name": "TODD",
        "middle_name": "ROBERT",
        "credential": "M.D., PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-15",
        "last_updated": "2023-08-21",
        "certification_date": "2023-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "WA",
            "license": "MD 60125691",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kate Klein
• Katherine Denison Klein, PH.D.
• Mariola T Klein, DOULA
• Emily Klemisch
• Laurie Klemmedson, LMP
• Samantha A Klim, ND
• Carolyn Roberta Kline, MD, MPH
• Valery Klionsky, LMP
• Addison Kloeckner
• Kayla Kloeckner

• Ophthalmology Physician in Bellevue, WA
• Providers in Bellevue, WA by specialty
• Ophthalmology Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.