Individual provider Active NPI

Andrew Ronald Klutman

  • Emergency Medicine Physician
  • Thornton, CO
National Provider Identifier
1730467994
Registry record updated Jul 30, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
DR.0054179 Issued in CO
Practice address
9191 Grant St
Thornton, CO 80229-4361
Phone
(303) 451-7800
NPI assigned
Jul 21, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 30, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X DR.0054179 CO Primary

Addresses

Primary practice location

9191 Grant St
Thornton, CO 80229-4361

Mailing address

P.O. Box 173862
Denver, CO 80217-3862
Phone (303) 306-7783

Other identifiers 1

IdentifierTypeStateIssuer
76854779MedicaidCO

Other names 1

  • Andrew R. Klutman Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE
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
I20141022001823 NE Practitioner - Emergency Medicine 5698995066 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
University of Nebraska College of Medicine, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Nebraska Emergency Medicine PCGroup PAC ID 4587651922, 31 clinicians

Practice addresses (Care Compare)

2300 S 16TH St
Lincoln, NE 68502-3704
Phone (402) 481-9049

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
93.5 of 100Reported as group
Quality
90.88
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
DR.0054179COMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Nebraska Emergency Medicine PC Emergency Medicine CurrentSince May 15, 2022 Accepting new patients

Locations

1600 S 48th St
Lincoln, NE 68506
Phone (402) 481-9049

2300 S 16th St
Lincoln, NE 68502
Phone (402) 434-6042

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 and National Provider Directory roles.

Hospital & facility affiliations 3

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": "1311206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1438214400000",
    "number": "1730467994",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 173862",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802173862",
            "telephone_number": "303-306-7783",
            "fax_number": "303-306-7753"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9191 GRANT ST",
            "city": "THORNTON",
            "state": "CO",
            "postal_code": "802294361",
            "telephone_number": "303-451-7800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLUTMAN",
        "first_name": "ANDREW",
        "middle_name": "RONALD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-07-21",
        "last_updated": "2015-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CO",
            "license": "DR.0054179",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "76854779",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANDREW",
            "last_name": "KLUTMAN",
            "middle_name": "R.",
            "credential": "MD",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Thornton, CO

Sources for this page

Verify at the official NPI Registry.