Richard Klementavicius, M.D.

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

License

ME77791 Issued in FL

Practice address

617 Bay Cliffs Rd
Gulf Breeze, FL 32561-4805

Phone

(850) 934-4107

Fax

(850) 934-4107

NPI assigned

May 17, 2006

Last updated

Nov 2, 2010By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 5

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

Specialty

Anesthesiology

Education

Other, 1982

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Anesthesia Dynamics LLCGroup PAC ID 3779832530, 883 clinicians

Ams Baptist LLCGroup PAC ID 6901099688, 80 clinicians

Ams National LLCGroup PAC ID 3870813025, 310 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Baptist Hospital Hospital, Pensacola, FL, CCN 100093

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Ams Baptist LLC

  • Anesthesiology Physician
  • Pensacola, FL
  • NPI 1093020216
  Medicare reassignment Care Compare group NPD
• Ams National LLC

  • Anesthesiology Physician
  • Pensacola, FL
  • NPI 1316330830
  Medicare reassignment Care Compare group NPD
• Anesthesia Dynamics LLC

  • Anesthesiology Physician
  • Bradenton, FL
  • NPI 1073001012
  Medicare reassignment Care Compare group NPD
• Ams of Gulf Breeze LLC

  • Anesthesiology Physician
  • Pensacola, FL
  • NPI 1376812032
  Medicare reassignment NPD
• Fleming Island Anesthesia LLC

  • Anesthesiology Physician
  • Orange Park, FL
  • NPI 1487945895
  Medicare reassignment NPD
• Anesthesia Health Care Partners of Florida Inc

  • Anesthesiology Physician
  • Orlando, FL
  • NPI 1518915545
  NPD (past)
• The Anesthesia Group, P.a.

  • Anesthesiology Physician
  • Pensacola, FL
  • NPI 1871532226
  NPD (past)

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

• Baptist Health Care, Inc

  • General Acute Care Hospital
  • Pensacola, FL
  • NPI 1700979465
  Care Compare affiliation

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

{
    "created_epoch": "1147824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1288656000000",
    "number": "1609828490",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "617 BAY CLIFFS RD",
            "city": "GULF BREEZE",
            "state": "FL",
            "postal_code": "325614805",
            "telephone_number": "850-934-4107",
            "fax_number": "850-934-4107"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "617 BAY CLIFFS RD",
            "city": "GULF BREEZE",
            "state": "FL",
            "postal_code": "325614805",
            "telephone_number": "850-934-4107",
            "fax_number": "850-934-4107"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLEMENTAVICIUS",
        "first_name": "RICHARD",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-17",
        "last_updated": "2010-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "FL",
            "license": "ME77791",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "46336",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "59169917",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "009984555",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "256621400",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PALMETTO GBA-RR MEDICARE",
            "identifier": "P00134526",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kelsey Kinnebrew
• Daniel Kipp, PTA
• Michelle Elise Kistler, LCSW
• Pamela M Klein, MD
• Jolita Klementaviciene, MD
• Marjorie Lewis Kovac, ARNP
• Jessica Sue Koziara
• Steven C Kronlage, M.D.
• Kevin P. Krueger, PT
• Celeste Krys, OTR/L

• Anesthesiology Physician in Gulf Breeze, FL
• Providers in Gulf Breeze, FL by specialty
• Anesthesiology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2010; 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.