Active NPI
Pawel Patryk Klimkiewicz, FNP
- Family Nurse Practitioner
- Champlain, NY
National Provider Identifier
1972029585
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 341848
- Practice address
- 828 State Route 11
Champlain, NY 12919-4966 - Phone
- (518) 298-2691
- Fax
- (518) 298-8241
- NPI assigned
- Aug 15, 2017
- Last updated
- Oct 7, 2026
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 341848 | NY | Primary |
Addresses
Primary practice location
828 State Route 11
Champlain, NY 12919-4966
Mailing address
9 Carey Rd
Queensbury, NY 12804-7880
Phone (518) 761-0300
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 04823649 | Medicaid | NY |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | pawel.klimkiewicz.1@1823.direct.athenahealth.com |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2017
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
828 State Route 11
Champlain, NY 12919-4966
Phone (518) 298-2691
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Hudson Headwaters Health Network | Current | Accepting new patients | |
| Hudson Headwaters Health Network | Past | Accepting new patients | |
| Hudson Headwaters Health Network | Past | Accepting new patients |
Locations
828 State Route 11
Champlain, NY 12919
Phone (518) 298-2691
9 Carey Rd
Queensbury, NY 12804
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Primary Care Clinic/Center
- Warrensburg, NY
- NPI 1194738344
-
- Primary Care Clinic/Center
- Queensbury, NY
- NPI 1386657534
-
- Primary Care Clinic/Center
- Champlain, NY
- NPI 1245285170
-
- Primary Care Clinic/Center
- Indian Lake, NY
- NPI 1548276801
Hospital & facility affiliations 5
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Plattsburgh, NY
- NPI 1033270699
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1502755200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1791331200000",
"number": "1972029585",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9 CAREY RD",
"city": "QUEENSBURY",
"state": "NY",
"postal_code": "128047880",
"telephone_number": "518-761-0300"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "828 STATE ROUTE 11",
"city": "CHAMPLAIN",
"state": "NY",
"postal_code": "129194966",
"telephone_number": "518-298-2691",
"fax_number": "518-298-8241"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KLIMKIEWICZ",
"first_name": "PAWEL",
"middle_name": "PATRYK",
"credential": "FNP",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-08-15",
"last_updated": "2026-10-07",
"certification_date": "2026-10-07",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "NY",
"license": "341848",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "04823649",
"state": "NY"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "pawel.klimkiewicz.1@1823.direct.athenahealth.com",
"affiliation": "N",
"address_1": "828 State Route 11",
"city": "Champlain",
"state": "NY",
"country_code": "US",
"postal_code": "129194966",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Champlain, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2026; 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.