Active NPI
R Steven Klatt
- Surgical Physician Assistant
- Park City, UT
National Provider Identifier
1710995386
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgical Physician Assistant
- License
- 284844-1206
- Practice address
- 1820 Sidewinder Dr
Park City, UT 84060-7492 - Phone
- (435) 655-6600
- NPI assigned
- Aug 3, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgical Physician Assistant | 363AS0400X | 284844-1206 | UT | Primary |
Addresses
Primary practice location
1820 Sidewinder Dr
Park City, UT 84060-7492
Mailing address
1820 Sidewinder Dr
Park City, UT 84060-7492
Phone (435) 655-6600
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| QM0000051402 | Other | UT | ALTIUS HEALTH PLANS |
| 62500 | Other | UT | PUBLIC EMPLOYEES HEALTH P |
| 107012319101 | Other | UT | SELECTHEALTH |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 284844-1206 | UT | MD | Surgical Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154563200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1192060800000",
"number": "1710995386",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1820 SIDEWINDER DR",
"city": "PARK CITY",
"state": "UT",
"postal_code": "840607492",
"telephone_number": "435-655-6600"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1820 SIDEWINDER DR",
"city": "PARK CITY",
"state": "UT",
"postal_code": "840607492",
"telephone_number": "435-655-6600"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KLATT",
"first_name": "R",
"middle_name": "STEVEN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-03",
"last_updated": "2007-10-11",
"status": "A"
},
"taxonomies": [
{
"code": "363AS0400X",
"taxonomy_group": "",
"desc": "Physician Assistant, Surgical",
"state": "UT",
"license": "284844-1206",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ALTIUS HEALTH PLANS",
"identifier": "QM0000051402",
"state": "UT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PUBLIC EMPLOYEES HEALTH P",
"identifier": "62500",
"state": "UT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "SELECTHEALTH",
"identifier": "107012319101",
"state": "UT"
}
],
"endpoints": [],
"other_names": []
}Other providers in Park City, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.