David J Kleczek, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA9101629 Issued in FL

Practice address

381 Ruin Creek Rd
Henderson, NC 27536-2932

Phone

(252) 430-0666

Fax

(252) 430-7503

NPI assigned

Jul 21, 2006

Last updated

Jan 14, 2013By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NC

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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.

• Vance Family Medicine, PA

  • Rural Health Clinic/Center
  • Henderson, NC
  • NPI 1619938479
  Medicare reassignment

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

{
    "created_epoch": "1153440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1358121600000",
    "number": "1982625414",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "381 RUIN CREEK RD",
            "city": "HENDERSON",
            "state": "NC",
            "postal_code": "275362932",
            "telephone_number": "252-430-0666",
            "fax_number": "252-430-7503"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "381 RUIN CREEK RD",
            "city": "HENDERSON",
            "state": "NC",
            "postal_code": "275362932",
            "telephone_number": "252-430-0666",
            "fax_number": "252-430-7503"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLECZEK",
        "first_name": "DAVID",
        "middle_name": "J",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-21",
        "last_updated": "2013-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9101629",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-02941",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shareka Nacole King, LCSW-A
• Kirby J. Ransom DMD PA
• Cara White Kirby
• Kirit D Trivedi MD PA
• Alyssa Klassa, PA-C
• Young H Ko, MD
• Claudia Kostich, ATC, LAT
• KSB Transportation
• Levina Kumar, PMHNP-BC
• Danielle Renee Kwakye-Berko, MD

• Physician Assistant in Henderson, NC
• Providers in Henderson, NC by specialty
• Physician Assistant in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2013; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.