Individual provider Active NPI

Kyle Jay Klahs, DO

  • Orthopaedic Surgery Physician
  • Fort Drum, NY
National Provider Identifier
1710476528
Registry record updated Apr 21, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
323230-01 Issued in NY
Practice address
11050 Mt Belvedere Blvd
Fort Drum, NY 13602-2603
Phone
(315) 772-6091
NPI assigned
May 7, 2018
Last updated
Apr 21, 2026By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 21, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X 323230-01 NY Primary

Addresses

Primary practice location

11050 Mt Belvedere Blvd
Fort Drum, NY 13602-2603

Mailing address

11050 Mt Belvedere Blvd
Fort Drum, NY 13602-2603
Phone (315) 772-6091

Other practice location 1

22567 Summit Dr
Watertown, NY 13601-7210
Phone (315) 779-6784

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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

Enrollment IDStateProvider typePAC IDDetails
I20231026000137 NY Practitioner - Orthopedic Surgery 9032565148 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Samaritan Medical Practice PCGroup PAC ID 5698853133, 29 clinicians

Practice addresses (Care Compare)

22567 Summit Dr
Watertown, NY 13601-7210
Phone (315) 779-6784

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hip replacement1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
323230-01NYMDOrthopaedic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Samaritan Medical Practice, PC CurrentSince Oct 1, 2023 Accepting new patients

Locations

22567 Summit Dr
Watertown, NY 13601
Phone (315) 779-6784

22567 Summit Dr
Bldg 2
Watertown, NY 13601
Phone (315) 779-6784

629 Washington St
Watertown, NY 13601
Phone (315) 755-3650

Interoperability endpoints

  • Direct secure messaging: kyle.klahs@direct.myhealthep.org
  • Direct secure messaging: kklahs@samaritanmedicalpractice.medentdirect.com

Organizations & group practices 1

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.

Hospital & facility affiliations 1

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": "1525651200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776729600000",
    "number": "1710476528",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11050 MT BELVEDERE BLVD",
            "city": "FORT DRUM",
            "state": "NY",
            "postal_code": "136022603",
            "telephone_number": "315-772-6091"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11050 MT BELVEDERE BLVD",
            "city": "FORT DRUM",
            "state": "NY",
            "postal_code": "136022603",
            "telephone_number": "315-772-6091"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "22567 Summit Dr",
            "address_purpose": "LOCATION",
            "city": "Watertown",
            "state": "NY",
            "postal_code": "136017210",
            "country_code": "US",
            "telephone_number": "315-779-6784",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KLAHS",
        "first_name": "KYLE",
        "middle_name": "JAY",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-05-07",
        "last_updated": "2026-04-21",
        "certification_date": "2026-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "NY",
            "license": "323230-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Drum, NY

Sources for this page

Verify at the official NPI Registry.