Individual provider Active NPI

Ana Rebecca Klenz, MD

  • Internal Medicine Physician
  • Melbourne, FL
National Provider Identifier
1477613271
Registry record updated Jul 8, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME144306 Issued in FL
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

Updated by the provider on Jul 8, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Hospitalist Physician 208M00000X ME144306 FL
Internal Medicine PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 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

IdentifierTypeStateIssuer
106733000MedicaidFL
MP473OtherFLMEDICARE

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200623000403 FL Practitioner - Internal MedicinePractitioner - Hospitalist 6800998014 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME144306FLMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Suntree Endocrinology Single Specialty Current Accepting new patients
Suntree Internal Medicine, LLC. Single Specialty CurrentSince Sep 14, 2020 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.

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

Verify at the official NPI Registry.