NPIMap

Individual provider Active NPI

Kyle Klitsch, D.O

  • Physical Medicine & Rehabilitation Physician
  • Allentown, PA
National Provider Identifier
1619108412
Registry record updated Dec 11, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
OT0130056 Issued in PA
Practice address
850 S 5TH Street
Allentown, PA 18103-3295
Phone
(610) 778-1050
NPI assigned
Jul 28, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 11, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X OT0130056 PA Primary

Addresses

Primary practice location

850 S 5TH Street
Allentown, PA 18103-3295

Mailing address

850 S 5TH Street
Allentown, PA 18103-3295
Phone (610) 778-1050

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130809000317 PA Practitioner - Physical Medicine and Rehabilitation 9931341682 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Medicine and Rehabilitation
Education
Philadelphia College of Osteopathic Medicine, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

850 S 5TH St
Allentown, PA 18103-3308
Phone (610) 776-3214

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
86.29 of 100Reported as individual
Quality
58.72
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
OT0130056PAMDPhysical Medicine & Rehabilitation Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Good Shepherd Rehabilitation Hospital Physical Medicine & Rehabilitation CurrentSince Jul 15, 2013 Accepting new patients
Good Shepherd Rehabilitation Hospital CurrentSince Jul 15, 2013 Accepting new patients

Locations

850 S 5th St
Allentown, PA 18103
Phone (610) 776-3278

3200 Center Valley Pkwy
Center Valley, PA 18034
Phone (610) 242-0345

510 Brookmont Dr
Effort, PA 18330
Phone (610) 681-4070

Interoperability endpoints

  • Direct secure messaging: kyle.klitsch.1@11391.direct.athenahealth.com
  • FHIR API: https://api.platform.athenahealth.com/11391/brand/2/csg/21/fhir/r4

Organizations & group practices 2

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 12

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": "1248739200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1386720000000",
    "number": "1619108412",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "850 S 5TH STREET",
            "city": "ALLENTOWN",
            "state": "PA",
            "postal_code": "181033295",
            "telephone_number": "610-778-1050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "850 S 5TH STREET",
            "city": "ALLENTOWN",
            "state": "PA",
            "postal_code": "181033295",
            "telephone_number": "610-778-1050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLITSCH",
        "first_name": "KYLE",
        "credential": "D.O",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-07-28",
        "last_updated": "2013-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "PA",
            "license": "OT0130056",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Allentown, PA

Sources for this page

Verify at the official NPI Registry.