Charles R. Klettner, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

4301063386 Issued in MI

Practice address

5015 N Royal Drive
Traverse City, MI 49684

Phone

(231) 935-0850

Fax

(231) 935-0869

NPI assigned

Mar 21, 2006

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

Other identifiers 2

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in MI

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

Specialty

Internal Medicine

Education

Wayne State University School of Medicine, 1994

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Grand Traverse Internists PCGroup PAC ID 0042374977, 8 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Munson Medical Center Hospital, Traverse City, MI, CCN 230097
• Kalkaska Memorial Health Center Hospital, Kalkaska, MI, CCN 231301
• Paul Oliver Memorial Hospital Hospital, Frankfort, MI, CCN 231300

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/FIAHAA

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.

• Grand Traverse Internists, PC

  • Internal Medicine Physician
  • Traverse City, MI
  • NPI 1578559365
  Medicare reassignment Care Compare group NPD
• Munson Medical Center

  • Endocrinology, Diabetes & Metabolism Physician
  • Traverse City, MI
  • NPI 1083761860
  Medicare reassignment NPD
• Munson Medical Center

  • Family Medicine Physician
  • Traverse City, MI
  • NPI 1881623031
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Kalkaska Memorial Health Center

  • Critical Access Hospital
  • Kalkaska, MI
  • NPI 1497751309
  Care Compare affiliation
• Munson Medical Center

  • General Acute Care Hospital
  • Traverse City, MI
  • NPI 1952307852
  Care Compare affiliation
• Paul Oliver Memorial Hospital

  • Critical Access Hospital
  • Frankfort, MI
  • NPI 1427054360
  Care Compare affiliation

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

{
    "created_epoch": "1142899200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603324800000",
    "number": "1760441646",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5015 N ROYAL DRIVE",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "49684",
            "telephone_number": "231-935-0850",
            "fax_number": "231-935-0869"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5015 N ROYAL DRIVE",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "49684",
            "telephone_number": "231-935-0850",
            "fax_number": "231-935-0869"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLETTNER",
        "first_name": "CHARLES",
        "middle_name": "R.",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-21",
        "last_updated": "2020-10-22",
        "certification_date": "2020-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301063386",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSM",
            "identifier": "1102803182",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3367082",
            "state": "MI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "charles.klettner@gti.eclinicaldirectplus.com",
            "affiliation": "N",
            "endpointDescription": "direct trust email",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "5015 N Royal Drive",
            "city": "Traverse City",
            "state": "MI",
            "country_code": "US",
            "postal_code": "49684",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Steven Paul Klegman, DO
• Megan K Kleiber
• Cassidy F Klein, DPT
• Kurt Robert Klein, M.A., L.P.C.
• Emilie Klemptner, M.S., R.D.
• Lisa Louise Kleyps, LMT
• Michelle L Klindera
• Lauren E Kline
• Emily Anne Klintworth, FNP
• Ashlynne Nicole Klocko

• Internal Medicine Physician in Traverse City, MI
• Providers in Traverse City, MI by specialty
• Internal Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2020; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.