Matthew Klics, PA-C

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

0200111 Issued in NY

Practice address

635 Belle Terre Rd
Suite 204
Port Jefferson, NY 11777-1935

Phone

(631) 474-0008

NPI assigned

Aug 12, 2016

Sex

Male

Sole proprietor

Yes

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 NY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

State University of New York at Stony Brook, School of Medicine, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

True North Medical Group PCGroup PAC ID 7012194806, 185 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

93.07 of 100Reported as apm

Quality

79.77

Promoting interoperability

88.77

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Networks

• Healthfirst Medicare Network H3359
• Healthfirst Medicare Network H5989
• Healthfirst Medicare Network H9678
• Healthfirst Medicare Network H1722

Interoperability endpoints

• Direct secure messaging: matthewklics@nslijmedgr.allscriptsdirect.net
• Direct secure messaging: matthewklics@ossm.allscriptsdirect.net

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.

• True North Medical Group PC

  • Orthopaedic Surgery Physician
  • Merrick, NY
  • NPI 1659883486
  Medicare reassignment Care Compare group NPD
• Orthopaedics Spine and Sports Medicine LLC

  • Orthopaedic Surgery Physician
  • Syosset, NY
  • NPI 1548490063
  Medicare reassignment NPD
• Orthopaedics Spine and Sports Medicine, LLC

  • Durable Medical Equipment & Medical Supplies
  • Syosset, NY
  • NPI 1073096590
  NPD
• True North Medical Group PC

  • Oxygen Equipment & Supplies (DME)
  • Tarrytown, NY
  • NPI 1669272886
  NPD
• Orthopaedics Spine and Sports Medicine LLC

  • Orthopaedic Surgery of the Spine Physician
  • Bayonne, NJ
  • NPI 1154030328
  NPD
• True North Medical Group PC

  • Cardiovascular Disease Physician
  • Bayside, NY
  • NPI 1669762258
  NPD (past)

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

{
    "created_epoch": "1470960000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1476835200000",
    "number": "1972057529",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "635 BELLE TERRE RD",
            "address_2": "SUITE 204",
            "city": "PORT JEFFERSON",
            "state": "NY",
            "postal_code": "117771935"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "635 BELLE TERRE RD",
            "address_2": "SUITE 204",
            "city": "PORT JEFFERSON",
            "state": "NY",
            "postal_code": "117771935",
            "telephone_number": "631-474-0008"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLICS",
        "first_name": "MATTHEW",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-08-12",
        "last_updated": "2016-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "NY",
            "license": "0200111",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rebecca C Kirschner, CCC
• KK NP in Adult Health LLP
• Robert Klare, PT, CHT
• Joel Kleinberg, MD
• Roger A Kleinman, DDS
• Aundrea Eliza Knapp
• Lori-Ann Kneessy
• Gregg Michael Knel
• Ekta Kohli, LCSW
• Alexandros Konstantinidis, DO

• Surgical Physician Assistant in Port Jefferson, NY
• Providers in Port Jefferson, NY by specialty
• Surgical Physician Assistant in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2016; 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.