NPIMap

Individual provider Active NPI

Matthew Kliethermes, M.D.

  • Student in an Organized Health Care Education/Training Program
  • Lubbock, TX
National Provider Identifier
1417303363
Registry record updated May 10, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
Texas Tech Univ Health Sciences Ctr
3601 4TH Street
Lubbock, TX 79430-0001
Phone
(806) 743-1000
NPI assigned
May 10, 2016
Last updated
May 10, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 10, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

Texas Tech Univ Health Sciences Ctr
3601 4TH Street
Lubbock, TX 79430-0001

Mailing address

3601 4TH Street
Texas Tech Univ. Health Sciences Center
Lubbock, TX 79430
Phone (806) 743-1000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190816000938 CA Practitioner - Ophthalmology 7719271253 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
University of Missouri, Kansas City, School of Medicine, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Visalia Eye Center IncGroup PAC ID 0345264222, 3 clinicians

Practice addresses (Care Compare)

112 N Akers St
Suite a
Visalia, CA 93291-5121
Phone (559) 733-4372

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery279

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Visalia Eye Center, Inc. Current Accepting new patients
Courtyard Surgery Pavilion, Inc Current Accepting new patients
Visalia Eye Center, Inc. CurrentSince Aug 15, 2019 Accepting new patients
Kaweah Delta Health Care District Past Accepting new patients
Lubbock County Hospital District Past Accepting new patients

Locations

112 N Akers St
Visalia, CA 93291
Phone (559) 733-4372

112 N Akers St
Ste A
Visalia, CA 93291
Phone (559) 733-4372

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 4

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": "1462838400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1462838400000",
    "number": "1417303363",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3601 4TH STREET",
            "address_2": "TEXAS TECH UNIV. HEALTH SCIENCES CENTER",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "79430",
            "telephone_number": "806-743-1000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "TEXAS TECH UNIV HEALTH SCIENCES CTR",
            "address_2": "3601 4TH STREET",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794300001",
            "telephone_number": "806-743-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLIETHERMES",
        "first_name": "MATTHEW",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-05-10",
        "last_updated": "2016-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lubbock, TX

Sources for this page

Verify at the official NPI Registry.