Individual provider Active NPI

Kyle Kluck, DO

  • Student in an Organized Health Care Education/Training Program
  • Rochester, MI
National Provider Identifier
1487448619
Registry record updated Jan 22, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
1135 W University Dr Ste 250
Rochester, MI 48307-1886
Phone
(248) 650-6301
Fax
(248) 601-7637
NPI assigned
Apr 4, 2025
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 22, 2026

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

1135 W University Dr Ste 250
Rochester, MI 48307-1886

Mailing address

1135 W University Dr Ste 250
Rochester, MI 48307-1886
Phone (248) 650-6301

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20250822001783 MI Order and Referring Only - Family PracticePractitioner - Family Practice 4981104122

National Provider Directory

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

Interoperability endpoints

  • Direct secure messaging: kkluck734962@direct.hfhs.org

NPI Registry JSON

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

{
    "created_epoch": "1743724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1769040000000",
    "number": "1487448619",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1135 W UNIVERSITY DR STE 250",
            "city": "ROCHESTER",
            "state": "MI",
            "postal_code": "483071886",
            "telephone_number": "248-650-6301",
            "fax_number": "248-601-7637"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1135 W UNIVERSITY DR STE 250",
            "city": "ROCHESTER",
            "state": "MI",
            "postal_code": "483071886",
            "telephone_number": "248-650-6301",
            "fax_number": "248-601-7637"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLUCK",
        "first_name": "KYLE",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-04-04",
        "last_updated": "2026-01-22",
        "certification_date": "2026-01-22",
        "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 Rochester, MI

Sources for this page

Verify at the official NPI Registry.