Jesse M. Niederklein, D.O.

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

License

4543 Issued in KS

Practice address

1 Mt. Carmel Way
Pitsburg, KS 66762

Phone

(620) 231-6100

Fax

(620) 231-0081

NPI assigned

Feb 8, 2010

Last updated

Feb 4, 2016By 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 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in KS

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, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Mercy Clinic Pittsburg LLCGroup PAC ID 7618418088, 45 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Mercy Hospital Pittsburg, Inc Hospital, Pittsburg, KS, CCN 170006

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jesse.niederklein@khindirect.org

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.

• Mercy Clinic Pittsburg LLC

  • Internal Medicine Physician
  • Pittsburg, KS
  • NPI 1912751884

  Anesthesiology

  Medicare reassignment Care Compare group NPD
• Ascension Via Christi Hospital Pittsburg, Inc.

  dba Professional Services

  • Internal Medicine Physician
  • Pittsburg, KS
  • NPI 1760408975

  Anesthesiology

  Medicare reassignment NPD
• Hospital District No 1 Crawford County

  • Nurse Practitioner
  • Girard, KS
  • NPI 1508897182

  Anesthesiology

  Medicare reassignment NPD
• Hospital District No 1 Crawford County

  dba Girard Medical Center of Fort Scott

  • Rural Health Clinic/Center
  • Fort Scott, KS
  • NPI 1093426470
  NPD
• Pathology Laboratory Associates, Inc.

  • Anatomic Pathology & Clinical Pathology Physician
  • Tulsa, OK
  • NPI 1750314076
  NPD
• Regional Medical Laboratory, Inc

  • Clinical Medical Laboratory
  • Tulsa, OK
  • NPI 1497773337
  NPD

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

• Mercy Hospital Pittsburg Inc

  • General Acute Care Hospital
  • Pittsburg, KS
  • NPI 1639921430
  Care Compare affiliation

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

{
    "created_epoch": "1265587200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1454544000000",
    "number": "1710219225",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 MT CARMEL WAY",
            "city": "PITTSBURG",
            "state": "KS",
            "postal_code": "667627587",
            "telephone_number": "620-231-7600",
            "fax_number": "620-231-0081"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 MT. CARMEL WAY",
            "city": "PITSBURG",
            "state": "KS",
            "postal_code": "66762",
            "telephone_number": "620-231-6100",
            "fax_number": "620-231-0081"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NIEDERKLEIN",
        "first_name": "JESSE",
        "middle_name": "M.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-02-08",
        "last_updated": "2016-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "OK",
            "license": "4543",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "KS",
            "license": "4543",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200654320A",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2016; 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.