Clayton Kline
Individual provider Active NPI Physician Assistant · Buhl, ID
NPI 1982229944 · NPPES record last updated Jan 4, 2022
Key facts
- NPI
- 1982229944
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 363A00000X
- License
- 085008738 (IL)
- Practice address
- 881 E 3900 N
Buhl, ID 83316-5929 - Phone
- (208) 308-6841
- NPI assigned
- Jun 15, 2020
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 4
Medicare Care Compare profile
Merit-based Incentive Payment System (MIPS)
- Final score
- 84.9 of 100
- Quality
- 75.91
- Promoting interoperability
- 99
- Improvement activities
- 40
- Cost
- 74.6
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IL
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20220131000599 | IL | Practitioner - Physician Assistant | 9032502844 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 085008738 | IL | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Endeavor Health Medical Group | Current |
Accepting new patients | |
| Cepamerica Illinois LLP | Current |
Accepting new patients | |
| Cepamerica Illinois LLP | Current |
Accepting new patients |
Locations
1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423
880 W Central Rd
Arlington Hts, IL 60005
Phone (847) 394-3553
3249 Oak Park Ave
Berwyn, IL 60402
Phone (708) 783-2696
9532 Eagle Way
Chicago, IL 60678
1425 N Randall Rd
Elgin, IL 60123
Phone (224) 783-5437
2650 Ridge Ave
Ste 2218A
Evanston, IL 60201
Phone (847) 503-4222
2650 Ridge Ave
Evanston, IL 60201
Phone (847) 570-1206
Interoperability endpoints
- clayton.kline.1@22028.direct.athenahealth.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Physician Assistant | 363A00000X | 085008738 | IL | Yes |
Addresses
Primary practice location
881 E 3900 N
Buhl, ID 83316-5929
Mailing address
881 E 3900 N
Buhl, ID 83316-5929
Phone (208) 308-6841
Other providers in Buhl, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 4, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.