Individual provider Active NPI

John Cooke Kluznik, MD

  • Psychiatry Physician
  • Crystal, MN
National Provider Identifier
1407846496
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
21665 Issued in MN
Practice address
2960 Winnetka Ave N
Suite 208
Crystal, MN 55427-2853
Phone
(763) 512-1090
NPI assigned
Oct 21, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 21665 MN Primary

Addresses

Primary practice location

2960 Winnetka Ave N
Suite 208
Crystal, MN 55427-2853

Mailing address

1042 Summit Ave
Saint Paul, MN 55105-3003
Phone (651) 293-1076

Other identifiers 15

IdentifierTypeStateIssuer
1567993OtherMEDMA
HP35359OtherHP
1567993OtherADVAN
1015832OtherPEAK
1567993OtherUHC U
49A22KLOtherEPNI
49A22KLOtherCCS
1015832OtherPRE 1
1015832OtherP1CHP
1567993OtherUHIC
1567993OtherUHC
49A22KLOtherB L
49A22KLOtherANTHE
1567993OtherMEDCA
49A22KLOtherBCBS

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
21665MNMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Richard H. Morse, MD a Prof. Med. Corp. Past Accepting new patients

Organizations & group practices 1

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": "1129852800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1407846496",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1042 SUMMIT AVE",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551053003",
            "telephone_number": "651-293-1076"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2960 WINNETKA AVE N",
            "address_2": "SUITE 208",
            "city": "CRYSTAL",
            "state": "MN",
            "postal_code": "554272853",
            "telephone_number": "763-512-1090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLUZNIK",
        "first_name": "JOHN",
        "middle_name": "COOKE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-21",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MN",
            "license": "21665",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDMA",
            "identifier": "1567993",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HP",
            "identifier": "HP35359",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ADVAN",
            "identifier": "1567993",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PEAK",
            "identifier": "1015832",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UHC U",
            "identifier": "1567993",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EPNI",
            "identifier": "49A22KL",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CCS",
            "identifier": "49A22KL",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PRE 1",
            "identifier": "1015832",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "P1CHP",
            "identifier": "1015832",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UHIC",
            "identifier": "1567993",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UHC",
            "identifier": "1567993",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "B L",
            "identifier": "49A22KL",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHE",
            "identifier": "49A22KL",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDCA",
            "identifier": "1567993",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "49A22KL",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Crystal, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; 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.