Active NPI
Ana Rebecca Klenz, MD
- Internal Medicine Physician
- Melbourne, FL
National Provider Identifier
1477613271
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- ME144306
- Practice address
- 6619 N Wickham Rd
Melbourne, FL 32940-2006 - Phone
- (321) 259-9500
- Fax
- (321) 574-8656
- NPI assigned
- Dec 11, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Hospitalist Physician | 208M00000X | ME144306 | FL | |
| Internal Medicine Physician | 207R00000X | ME144306 | FL | Primary |
Addresses
Primary practice location
6619 N Wickham Rd
Melbourne, FL 32940-2006
Mailing address
6619 N Wickham Rd
Melbourne, FL 32940-2006
Phone (321) 434-1771
Other practice location 1
1350 Hickory St
Melbourne, FL 32901-3224
Phone (321) 434-1771
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 106733000 | Medicaid | FL | |
| MP473 | Other | FL | MEDICARE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine, Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ME144306 | FL | MD | Hospitalist Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Suntree Endocrinology | Single Specialty | Current | Accepting new patients |
| Suntree Internal Medicine, LLC. | Single Specialty | Current | Accepting new patients |
Locations
6619 N Wickham Rd
Melbourne, FL 32940
Phone (321) 259-9500
Organizations & group practices 2
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.
-
- Internal Medicine Physician
- Melbourne, FL
- NPI 1700947884
Single Specialty
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1165795200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1594166400000",
"number": "1477613271",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6619 N WICKHAM RD",
"city": "MELBOURNE",
"state": "FL",
"postal_code": "329402006",
"telephone_number": "321-434-1771"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6619 N WICKHAM RD",
"city": "MELBOURNE",
"state": "FL",
"postal_code": "329402006",
"telephone_number": "321-259-9500",
"fax_number": "321-574-8656"
}
],
"practiceLocations": [
{
"address_1": "1350 Hickory St",
"address_purpose": "LOCATION",
"city": "Melbourne",
"state": "FL",
"postal_code": "329013224",
"country_code": "US",
"telephone_number": "321-434-1771",
"fax_number": "321-434-1775",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "KLENZ",
"first_name": "ANA",
"middle_name": "REBECCA",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-12-11",
"last_updated": "2020-07-08",
"certification_date": "2020-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "208M00000X",
"taxonomy_group": "",
"desc": "Hospitalist",
"state": "FL",
"license": "ME144306",
"primary": false
},
{
"code": "207R00000X",
"taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
"desc": "Internal Medicine",
"state": "FL",
"license": "ME144306",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "106733000",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE",
"identifier": "MP473",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Melbourne, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2020; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.