NPIMap

Individual provider Active NPI

Jonathan Klaucke, M.D.

  • Orthopaedic Surgery Physician
  • Sandpoint, ID
National Provider Identifier
1891056826
Registry record updated Oct 2, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
M14354 Issued in ID
Practice address
606 N Third Ave Ste 201
Sandpoint, ID 83864
Phone
(208) 263-8597
NPI assigned
Jun 6, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 2, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X M14354 ID Primary

Addresses

Primary practice location

606 N Third Ave Ste 201
Sandpoint, ID 83864

Mailing address

606 N Third Ave Ste 201
Sandpoint, ID 83864-1689

Other practice location 1

22 S Greene St
S11B
Baltimore, MD 21201-1595
Phone (410) 328-8915

Other practice location 2

520 N 3rd Ave
Sandpoint, ID 83864-1507
Phone (208) 263-8597

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID, TX2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20181207000710 ID Practitioner - Orthopedic Surgery 3375842578 Reassigns benefits to 2 organizations
I20200527000529 TX Practitioner - Orthopedic Surgery 3375842578 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
University of Massachusetts Medical School, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Alaska Native Tribal Health ConsortiumGroup PAC ID 6709780265, 605 clinicians
Bonner General Hospital IncGroup PAC ID 4082690466, 47 clinicians

Practice addresses (Care Compare)

4315 Diplomacy Dr
Anchorage, AK 99508-5926
Phone (907) 563-2662

606 N 3Rd Ave
Suite 201
Sandpoint, ID 83864-1689
Phone (208) 263-8597

Hospital & facility affiliations

  • Bonner General Hospital Hospital, Sandpoint, ID, CCN 131328
  • Alaska Native Medical Center Hospital, Anchorage, AK, CCN 020026

Merit-based Incentive Payment System (MIPS)

Final score
90.93 of 100Reported as group
Quality
70.1
Promoting interoperability
100
Improvement activities
40
Cost
83.01

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hip replacement1-10
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
M14354IDMDOrthopaedic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Bonner General Hospital Inc. CurrentSince Sep 25, 2018 Accepting new patients
Bonner General Hospital, Inc CurrentSince Oct 1, 2018 Accepting new patients
Alaska Native Tribal Health Consortium CurrentSince May 20, 2020 Accepting new patients
Bonner General Hospital, Inc Past Accepting new patients

Locations

4315 Diplomacy Dr
Anchorage, AK 99508
Phone (907) 729-1729

4000 Ambassador Dr
Anchorage, AK 99508
Phone (907) 729-1900

520 N Third Ave
Sandpoint, ID 83864
Phone (208) 263-0649

606 N Third Ave
Ste 201
Sandpoint, ID 83864
Phone (208) 263-8597

423 N Third Ave
Ste 210
Sandpoint, ID 83864
Phone (208) 263-1441

Interoperability endpoints

  • Direct secure messaging: jonathan.klaucke@bgh.gwaydirect.com

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 14

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

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1338940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1538438400000",
    "number": "1891056826",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "606 N THIRD AVE STE 201",
            "city": "SANDPOINT",
            "state": "ID",
            "postal_code": "838641689"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "606 N THIRD AVE STE 201",
            "city": "SANDPOINT",
            "state": "ID",
            "postal_code": "83864",
            "telephone_number": "208-263-8597"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "22 S Greene St",
            "address_2": "S11B",
            "address_purpose": "LOCATION",
            "city": "Baltimore",
            "state": "MD",
            "postal_code": "212011595",
            "country_code": "US",
            "telephone_number": "410-328-8915",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "520 N 3rd Ave",
            "address_purpose": "LOCATION",
            "city": "Sandpoint",
            "state": "ID",
            "postal_code": "838641507",
            "country_code": "US",
            "telephone_number": "208-263-8597",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KLAUCKE",
        "first_name": "JONATHAN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-06-06",
        "last_updated": "2018-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "ID",
            "license": "M14354",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sandpoint, ID

Sources for this page

Verify at the official NPI Registry.