Individual provider Active NPI

Paul L Klink, MD

  • Obesity Medicine (Family Medicine) Physician
  • State College, PA
National Provider Identifier
1942265111
Registry record updated Apr 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obesity Medicine (Family Medicine) PhysicianTaxonomy code 207QB0002X
License
MD043830E Issued in PA
Practice address
1850 E Park Ave Ste 312
State College, PA 16803-6706
Phone
(814) 689-3156
Fax
(814) 689-1954
NPI assigned
Apr 19, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 30, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD043830-E PA
Obesity Medicine (Family Medicine) Physician 207QB0002X MD043830E PA Primary

Addresses

Primary practice location

1850 E Park Ave Ste 312
State College, PA 16803-6706

Mailing address

1850 E Park Ave Ste 312
State College, PA 16803-6706
Phone (814) 689-3156

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20101122000134 PA Practitioner - Family PracticePractitioner - Other (Physician) 3072510551 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Mount Nittany Medical Center Health Services Inc Family Medicine CurrentSince Jan 1, 2020 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

141 Medical Park Ln
Bellefonte, PA 16823
Phone (814) 355-7322

143 Hospital Dr
Ste 312
State College, PA 16803
Phone (814) 235-2480

1850 E Park Ave
Ste 201
State College, PA 16803
Phone (814) 234-8800

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1145404800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1588204800000",
    "number": "1942265111",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1850 E PARK AVE STE 312",
            "city": "STATE COLLEGE",
            "state": "PA",
            "postal_code": "168036706",
            "telephone_number": "814-689-3156",
            "fax_number": "814-689-1954"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1850 E PARK AVE STE 312",
            "city": "STATE COLLEGE",
            "state": "PA",
            "postal_code": "168036706",
            "telephone_number": "814-689-3156",
            "fax_number": "814-689-1954"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLINK",
        "first_name": "PAUL",
        "middle_name": "L",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-19",
        "last_updated": "2020-04-30",
        "certification_date": "2020-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "MD043830-E",
            "primary": false
        },
        {
            "code": "207QB0002X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Obesity Medicine",
            "state": "PA",
            "license": "MD043830E",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in State College, PA

Sources for this page

Verify at the official NPI Registry.