Individual provider Active NPI

Alexander Klaz, M.D.

  • Family Medicine Physician
  • Indianapolis, IN
National Provider Identifier
1811989882
Registry record updated Sep 25, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
01038707 Issued in IN
Practice address
1829 Brassica LN
Indianapolis, IN 46217-7095
Phone
(317) 698-6883
Fax
(317) 782-1069
NPI assigned
Aug 16, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 01038707 IN Primary

Addresses

Primary practice location

1829 Brassica LN
Indianapolis, IN 46217-7095

Mailing address

1829 Brassica LN
Indianapolis, IN 46217-7095
Phone (317) 698-6883

Other identifiers 1

IdentifierTypeStateIssuer
100376420AMedicaidIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20100924001277 IN Practitioner - Family Practice 7012033244 Practice locations: Indianapolis, IN

National Provider Directory

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

NPI Registry JSON

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

{
    "created_epoch": "1124150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1474761600000",
    "number": "1811989882",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1829 BRASSICA LN",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462177095",
            "telephone_number": "317-698-6883",
            "fax_number": "317-782-1069"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1829 BRASSICA LN",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462177095",
            "telephone_number": "317-698-6883",
            "fax_number": "317-782-1069"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLAZ",
        "first_name": "ALEXANDER",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-16",
        "last_updated": "2016-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "01038707",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100376420A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.