Individual provider Active NPI

John Klein, MD

  • Family Medicine Physician
  • Palestine, TX
National Provider Identifier
1528071172
Registry record updated Feb 1, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
L5794 Issued in TX
Practice address
4201 S Loop 256
Palestine, TX 75801-8476
Phone
(903) 723-8533
NPI assigned
Aug 14, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 1, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X L5794 TX Primary

Addresses

Primary practice location

4201 S Loop 256
Palestine, TX 75801-8476

Mailing address

4201 S Loop 256
Palestine, TX 75801-8476
Phone (903) 723-8533

Other identifiers 1

IdentifierTypeStateIssuer
165747001MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20040805000652 TX Practitioner - Family Practice 0749251304 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Texas Southwestern Medical School at Dallas, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
East Texas Family Medicine PAGroup PAC ID 9436120086, 5 clinicians

Practice addresses (Care Compare)

4201 S Loop
Suite 256
Palestine, TX 75801-8476
Phone (903) 723-8533

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
L5794TXMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
East Texas Family Medicine PA Family Medicine CurrentSince Jul 19, 2004 Accepting new patients

Locations

4201 S Loop 256
Palestine, TX 75801
Phone (903) 723-8533

Organizations & group practices 1

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.

Hospital & facility affiliations 3

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": "1155513600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1359676800000",
    "number": "1528071172",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4201 S LOOP 256",
            "city": "PALESTINE",
            "state": "TX",
            "postal_code": "758018476",
            "telephone_number": "903-723-8533"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4201 S LOOP 256",
            "city": "PALESTINE",
            "state": "TX",
            "postal_code": "758018476",
            "telephone_number": "903-723-8533"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLEIN",
        "first_name": "JOHN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-14",
        "last_updated": "2013-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "L5794",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "165747001",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Palestine, TX

Sources for this page

Verify at the official NPI Registry.