Roger A Kleinman, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

045752 Issued in NY

Practice address

656 Main St
Port Jefferson, NY 11777-2203

Phone

(631) 928-9898

Fax

(631) 928-3701

NPI assigned

Apr 13, 2007

Last updated

Jul 8, 2007By 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 1

Addresses

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: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Action Wellness NP in Family Health PLLC

  • Family Nurse Practitioner
  • Ronkonkoma, NY
  • NPI 1295493187
  NPD (past)

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

{
    "created_epoch": "1176422400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1720202179",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "656 MAIN ST",
            "city": "PORT JEFFERSON",
            "state": "NY",
            "postal_code": "117772203",
            "telephone_number": "631-928-9898",
            "fax_number": "631-928-3701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "656 MAIN ST",
            "city": "PORT JEFFERSON",
            "state": "NY",
            "postal_code": "117772203",
            "telephone_number": "631-928-9898",
            "fax_number": "631-928-3701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLEINMAN",
        "first_name": "ROGER",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-13",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "045752",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Linda Karen Kirk, LCSW
• Rebecca C Kirschner, CCC
• KK NP in Adult Health LLP
• Robert Klare, PT, CHT
• Joel Kleinberg, MD
• Matthew Klics, PA-C
• Aundrea Eliza Knapp
• Lori-Ann Kneessy
• Gregg Michael Knel
• Ekta Kohli, LCSW

• General Practice Dentistry in Port Jefferson, NY
• Providers in Port Jefferson, NY by specialty
• General Practice Dentistry in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.