Individual provider Active NPI

Kevin E Klossner, M.D.

  • Pediatrics Physician
  • Penfield, NY
National Provider Identifier
1497723282
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
171573 Issued in NY
Practice address
2067 Fairport Nine Mile PT Rd
Penfield, NY 14526-1753
Phone
(585) 922-0460
Fax
(585) 922-0470
NPI assigned
Mar 9, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 171573 NY Primary

Addresses

Primary practice location

2067 Fairport Nine Mile PT Rd
Penfield, NY 14526-1753

Mailing address

2067 Fairport Nine Mile PT Rd
Penfield, NY 14526-1753
Phone (585) 922-0460

Other identifiers 1

IdentifierTypeStateIssuer
01134954MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20050303000725 NY Practitioner - Pediatric Medicine 7416901350 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
96.62 of 100Reported as apm
Quality
74.51
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Rochester General Hospital CurrentSince Dec 26, 2010 Accepting new patients
Rochester General Hospital Pediatrics Current Accepting new patients
Rochester General Hospital Past Accepting new patients

Locations

2067 Fairport Nine Mile Point Rd
Penfield, NY 14526
Phone (585) 377-5420

2200 Penfield Rd
Penfield, NY 14526
Phone (585) 377-6170

100 Kings Hwy S
Rochester, NY 14617
Phone (585) 922-0553

1425 Portland Ave
Rochester, NY 14621
Phone (585) 922-3122

Interoperability endpoints

  • Direct secure messaging: kklossner10570@direct.rochesterregional.org

Organizations & group practices 3

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": "1141862400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1497723282",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2067 FAIRPORT NINE MILE PT RD",
            "city": "PENFIELD",
            "state": "NY",
            "postal_code": "145261753",
            "telephone_number": "585-922-0460",
            "fax_number": "585-922-0470"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2067 FAIRPORT NINE MILE PT RD",
            "city": "PENFIELD",
            "state": "NY",
            "postal_code": "145261753",
            "telephone_number": "585-922-0460",
            "fax_number": "585-922-0470"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLOSSNER",
        "first_name": "KEVIN",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-09",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "171573",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01134954",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Penfield, NY

Sources for this page

Verify at the official NPI Registry.