NPIMap

Individual provider Active NPI

Mitchell Robert Klement, M.D

  • Orthopaedic Surgery Physician
  • Pewaukee, WI
National Provider Identifier
1750657904
Registry record updated Nov 9, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
69496 Issued in WI
Practice address
N15W28300 Golf Rd
Pewaukee, WI 53072
Phone
(262) 303-5055
Fax
(262) 303-5057
NPI assigned
Mar 31, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 9, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X MD461164 PA
Orthopaedic Surgery Physician 207X00000X 69496 WI Primary

Addresses

Primary practice location

N15W28300 Golf Rd
Pewaukee, WI 53072

Mailing address

N15W28300 Golf Rd
Pewaukee, WI 53072-4800
Phone (262) 303-5055

Other identifiers 1

IdentifierTypeStateIssuer
1750657904MedicaidWI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180621000532 WI Practitioner - Orthopedic Surgery 2860763596 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
George Washington University School of Medicine, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Advantage Physical Therapy and Sports Rehab, LLCGroup PAC ID 8022016336, shared by 3 NPIs, 289 clinicians

Practice addresses (Care Compare)

10222 74TH St
Kenosha, WI 53142-6810
Phone (262) 925-5020

9809 39TH Ave
Pleasant Prairie, WI 53158-3733
Phone (262) 925-5080

N15W28300 Golf Rd
Pewaukee, WI 53072-4800
Phone (262) 303-5055

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hip replacement37
Knee replacement84
Lower limb (leg) arthroscopy (minimally invasive joint repair)1-10
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
69496WIMDOrthopaedic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Orthopaedic Associates of Wisconsin SC Orthopaedic Surgery CurrentSince Sep 1, 2018 Accepting new patients
Orthopaedic Associates of Wisconsin, SC Orthopaedic Surgery CurrentSince Sep 1, 2018 Accepting new patients

Locations

285 S Moorland Rd
Brookfield, WI 53005
Phone (810) 331-0939

1231 S Rochester St
Ste 100
Mukwonago, WI 53149

N15W28300 Golf Rd
Pewaukee, WI 53072

Interoperability endpoints

  • Direct secure messaging: mklement87545@direct.phci.org

Organizations & group practices 2

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 6

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": "1333152000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1573257600000",
    "number": "1750657904",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "N15W28300 GOLF RD",
            "city": "PEWAUKEE",
            "state": "WI",
            "postal_code": "530724800",
            "telephone_number": "262-303-5055",
            "fax_number": "262-303-5057"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "N15W28300 GOLF RD",
            "city": "PEWAUKEE",
            "state": "WI",
            "postal_code": "53072",
            "telephone_number": "262-303-5055",
            "fax_number": "262-303-5057"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLEMENT",
        "first_name": "MITCHELL",
        "middle_name": "ROBERT",
        "name_prefix": "Dr.",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-03-31",
        "last_updated": "2019-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "PA",
            "license": "MD461164",
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "WI",
            "license": "69496",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1750657904",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pewaukee, WI

Sources for this page

Verify at the official NPI Registry.