Stephanie Jo Klutz, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA.0005428 Issued in CO

Practice address

2535 S Downing St Ste 180F
Denver, CO 80210-5847

Phone

(303) 762-0808

Fax

(303) 762-9292

NPI assigned

Jul 18, 2018

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Stephanie Jo Brolsma Former name

Medicare fee-for-service enrollment

Enrolled in MN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2018

Medicare assignment

May accept Medicare assignment

Group practices

Children's Health CareGroup PAC ID 2668370966, 76 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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 and National Provider Directory roles.

• Childrens Health Care

  • Pediatrics Physician
  • Minneapolis, MN
  • NPI 1932208808
  Medicare reassignment Care Compare group
• Portercare Adventist Health System

  dba Afme PC Erie

  • Family Medicine Physician
  • Erie, CO
  • NPI 1124323076
  NPD
• Portercare Adventist Health System

  dba AdventHealth Medical Group Urology at Lakewood

  • Urology Physician
  • Lakewood, CO
  • NPI 1942165626
  NPD
• Childrens Health Care

  • Hearing Aid Equipment
  • Minneapolis, MN
  • NPI 1790827905
  NPD
• Childrens Health Care

  • Children's Hospital
  • Minneapolis, MN
  • NPI 1881793750
  NPD
• Childrens Health Care

  dba Childrens Hospitals and Clinics of Minnesota

  • Children's Hospital
  • Saint Paul, MN
  • NPI 1629161781
  NPD (past)

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

{
    "created_epoch": "1531872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1585872000000",
    "number": "1639655079",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2535 S DOWNING ST STE 180F",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802105847",
            "telephone_number": "303-762-0808",
            "fax_number": "303-762-9292"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2535 S DOWNING ST STE 180F",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802105847",
            "telephone_number": "303-762-0808",
            "fax_number": "303-762-9292"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLUTZ",
        "first_name": "STEPHANIE",
        "middle_name": "JO",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-07-18",
        "last_updated": "2020-04-03",
        "certification_date": "2020-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CO",
            "license": "PA.0005428",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COLORADO DEPARTMENT OF REGULATORY AGENCIES",
            "identifier": "PA.0005428",
            "state": "CO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCCPA",
            "identifier": "1152106",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "STEPHANIE",
            "last_name": "BROLSMA",
            "middle_name": "JO",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Ahnisa Klu, LPCC
• Julianna Rivich Kluemper, PHARMD
• Elissa Kluger Harcsztark, SLP
• Brenda K Kluherz, FPNP
• Kathleen A Klun, CNS
• Carissa Klutzke, LCSW
• Madeline Kluz, LPCC
• Kly Ride LLC
• KMH Orthodontics, PLLC (KMH Orthodontics Central Park)
• KMS Transportation

• Physician Assistant in Denver, CO
• Providers in Denver, CO by specialty
• Physician Assistant in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2020; 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.