Individual provider Active NPI

Thomas James Klick Jr., PA-C

  • Surgical Physician Assistant
  • Troy, MI
National Provider Identifier
1972884740
Registry record updated Sep 7, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
5601006122 Issued in MI
Practice address
44201 Dequindre Rd
Troy, MI 48085-1117
Phone
(248) 964-5000
NPI assigned
Sep 7, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 7, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X 5601006122 MI Primary

Addresses

Primary practice location

44201 Dequindre Rd
Troy, MI 48085-1117

Mailing address

22516 Bayview Dr
Saint Clair Shores, MI 48081-2440
Phone (313) 580-2364

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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

Enrollment IDStateProvider typePAC IDDetails
I20120316000523 MI Practitioner - Physician Assistant 7517126147 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Michigan Orthopaedic Spine Surgeons PCGroup PAC ID 3779732466, 15 clinicians

Practice addresses (Care Compare)

1555 S Blvd E
Rochester Hills, MI 48307-5624
Phone (248) 215-8080

44201 Dequindre Rd
Troy, MI 48085-1117
Phone (248) 964-5000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Great Lakes Surgical Assistants, PLLC Surgical Past Accepting new patients

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 and National Provider Directory roles.

Hospital & facility affiliations 6

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

NPI Registry JSON

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

{
    "created_epoch": "1315353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1315353600000",
    "number": "1972884740",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22516 BAYVIEW DR",
            "city": "SAINT CLAIR SHORES",
            "state": "MI",
            "postal_code": "480812440",
            "telephone_number": "313-580-2364"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "44201 DEQUINDRE RD",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480851117",
            "telephone_number": "248-964-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLICK",
        "first_name": "THOMAS",
        "middle_name": "JAMES",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-09-07",
        "last_updated": "2011-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "MI",
            "license": "5601006122",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Troy, MI

Sources for this page

Verify at the official NPI Registry.