Individual provider Active NPI

Benjamin J Klennert, PA C

  • Medical Physician Assistant
  • Morgantown, WV
National Provider Identifier
1740369750
Registry record updated Feb 14, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
00944 Issued in WV
Practice address
1526 Mileground Rd
Morgantown, WV 26505-3745
Phone
(304) 296-2395
Fax
(304) 413-0055
NPI assigned
Nov 2, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 14, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 00944 WV Primary

Addresses

Primary practice location

1526 Mileground Rd
Morgantown, WV 26505-3745

Mailing address

1526 Mileground Rd
Morgantown, WV 26505-3745
Phone (304) 777-4044

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051115000505 WV Practitioner - Physician Assistant 6305865783 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ward Paine, MD, PLLCGroup PAC ID 1850478827, 2 clinicians

Practice addresses (Care Compare)

1526 Mileground Rd
Suite C
Morgantown, WV 26505-0423
Phone (304) 777-4044

Hospital & facility affiliations

  • West Virginia University Hospitals, Inc Hospital, Morgantown, WV, CCN 510001
  • Mon Health Medical Center Hospital, Morgantown, WV, CCN 510024

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
944WVMDMental Health Counselor
00944WVMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Harned Memorial Medical Clinic Inc Past Accepting new patients

Organizations & group practices 4

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": "1162425600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1297641600000",
    "number": "1740369750",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1526 MILEGROUND RD",
            "city": "MORGANTOWN",
            "state": "WV",
            "postal_code": "265053745",
            "telephone_number": "304-777-4044",
            "fax_number": "304-292-9578"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1526 MILEGROUND RD",
            "city": "MORGANTOWN",
            "state": "WV",
            "postal_code": "265053745",
            "telephone_number": "304-296-2395",
            "fax_number": "304-413-0055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLENNERT",
        "first_name": "BENJAMIN",
        "middle_name": "J",
        "name_prefix": "Mr.",
        "credential": "PA C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-02",
        "last_updated": "2011-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "WV",
            "license": "00944",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Morgantown, WV

Sources for this page

Verify at the official NPI Registry.