Ellen Marie Klink, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

01077146 Issued in IN

Practice address

1111 Ronald Reagan Pkwy
B1100
Avon, IN 46123-7085

Phone

(317) 948-2700

Fax

(317) 948-2959

NPI assigned

Jun 13, 2013

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in IN

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

Specialty

HospitalistAlso: Pediatric Medicine

Education

Other, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Iu Health Medical Group LLCGroup PAC ID 9638617913, 4,382 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Indiana University Health Hospital, Indianapolis, IN, CCN 150056
• Iu Health West Hospital Hospital, Avon, IN, CCN 150158

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: eklink@direct.iuhealth.org

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.

• Iu Health Medical Group, LLC

  • General Practice Physician
  • Indianapolis, IN
  • NPI 1326893777
  Medicare reassignment Care Compare group NPD
• University Family Physicians, Inc.

  • Family Medicine Physician
  • Indianapolis, IN
  • NPI 1043275787

  Internal Medicine

  Medicare reassignment NPD
• University Pediatric Associates, Inc.

  • Pediatrics Physician
  • Indianapolis, IN
  • NPI 1457396541
  Medicare reassignment NPD
• University Family Physicians, Inc.

  • Durable Medical Equipment & Medical Supplies
  • Indianapolis, IN
  • NPI 1669828042
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Indiana University Health West Hospital Inc

  • General Acute Care Hospital
  • Avon, IN
  • NPI 1063443455
  Care Compare affiliation Name & address match
• Indiana University Health Inc

  • General Acute Care Hospital
  • Indianapolis, IN
  • NPI 1144266024
  Care Compare affiliation

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

{
    "created_epoch": "1371081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612483200000",
    "number": "1538507397",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 N SHADELAND AVE",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462194959"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 RONALD REAGAN PKWY",
            "address_2": "B1100",
            "city": "AVON",
            "state": "IN",
            "postal_code": "461237085",
            "telephone_number": "317-948-2700",
            "fax_number": "317-948-2959"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLINK",
        "first_name": "ELLEN",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-06-13",
        "last_updated": "2021-02-05",
        "certification_date": "2021-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IN",
            "license": "01077146A",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IN",
            "license": "01077146",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "eklink@direct.iuhealth.org",
            "affiliation": "N",
            "address_1": "1111 Ronald Reagan Pkwy",
            "address_2": "B1100",
            "city": "Avon",
            "state": "IN",
            "country_code": "US",
            "postal_code": "461237085",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Iman M. Kiritsis, MSW, LSW
• Cameron Wade Kirk, MD
• Gehna Kishore, MD
• Thomas Kixmiller, MA, LMHC
• Amy Marie Kline
• Angela Sue Klooz
• Justin Mark Klopp, OD
• Jessica E Knopp, MD
• Jessica Knudsen
• Melissa C Knutson, DO

• Pediatrics Physician in Avon, IN
• Providers in Avon, IN by specialty
• Pediatrics Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2021; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.