Nathan Andrew Kludt, MD

Primary specialty

Plastic Surgery PhysicianTaxonomy code 208200000X

License

A110013 Issued in CA

Practice address

1805 N California St
Suite 405
Stockton, CA 95204-6037

Phone

(209) 870-7100

Fax

(209) 870-7116

NPI assigned

May 21, 2008

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

Medicare fee-for-service enrollment

Enrolled in CA

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

Plastic and Reconstructive SurgeryAlso: Hand Surgery

Education

Eastern Virginia Medical School, 2008

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

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.

• Nathan a. Kludt, MD, Inc

  • Medical Specialty Clinic/Center
  • Stockton, CA
  • NPI 1144670597
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1211328000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1412035200000",
    "number": "1841457355",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1805 N CALIFORNIA ST",
            "address_2": "SUITE 405",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952046037",
            "telephone_number": "209-870-7100",
            "fax_number": "209-870-7116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1805 N CALIFORNIA ST",
            "address_2": "SUITE 405",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952046037",
            "telephone_number": "209-870-7100",
            "fax_number": "209-870-7116"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLUDT",
        "first_name": "NATHAN",
        "middle_name": "ANDREW",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-05-21",
        "last_updated": "2014-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "CA",
            "license": "A110013",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shanell Kitson
• Kimberly Eyvonne Kjonaas
• Charles David Klass, DDS
• Michael Kent Klopping, O.D.
• Cody Klucznik
• Manisai Kmbuaar
• Steven Thomas Kmucha, MD, JD
• Doreen Lynn Knapp
• Karyne Knight Ortiz
• Caitlyn Knight

• Plastic Surgery Physician in Stockton, CA
• Providers in Stockton, CA by specialty
• Plastic Surgery Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2014; 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.