Melissa Anne Klenczar, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

4301083991 Issued in MI

Practice address

3226 Hidden Timber Dr
Suite a
Lake Orion, MI 48359-1598

Phone

(248) 391-1780

Fax

(248) 391-1862

NPI assigned

May 18, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Melissa Anne Kimball Former name

Electronic endpoints 1

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Family Practice

Education

Wayne State University School of Medicine, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Beaumont Medical Group- Specialty ServicesGroup PAC ID 7214299866, 868 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Beaumont Hospital Royal Oak Hospital, Royal Oak, MI, CCN 230130

Merit-based Incentive Payment System (MIPS)

Final score

84.37 of 100Reported as group

Quality

66.73

Promoting interoperability

100

Improvement activities

40

Cost

70.98

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mklenczar398834@epic00.shdirect.org
• Direct secure messaging: mklenczar14849@direct.beaumont.edu

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.

• Beaumont Medical Group- Specialty Services

  • Surgery Physician
  • Royal Oak, MI
  • NPI 1578072906
  Medicare reassignment Care Compare group NPD
• William Beaumont Hospital

  • General Acute Care Hospital
  • Royal Oak, MI
  • NPI 1083833875
  Medicare reassignment NPD
• William Beaumont Hospital

  • Family Medicine Physician
  • Royal Oak, MI
  • NPI 1326097148
  NPD
• William Beaumont Hospital

  • General Acute Care Hospital
  • Grosse Pointe, MI
  • NPI 1932396017
  NPD

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

• William Beaumont Hospital

  • General Acute Care Hospital
  • Troy, MI
  • NPI 1306825997
  Care Compare affiliation
• William Beaumont Hospital

  • General Acute Care Hospital
  • Royal Oak, MI
  • NPI 1689653305
  Care Compare affiliation
• William Beaumont Hospital

  • General Acute Care Hospital
  • Grosse Pointe, MI
  • NPI 1932396017
  Care Compare affiliation

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

{
    "created_epoch": "1179446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603324800000",
    "number": "1982812236",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3226 HIDDEN TIMBER DR",
            "address_2": "SUITE A",
            "city": "LAKE ORION",
            "state": "MI",
            "postal_code": "483591598",
            "telephone_number": "248-391-1780",
            "fax_number": "248-391-1862"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3226 HIDDEN TIMBER DR",
            "address_2": "SUITE A",
            "city": "LAKE ORION",
            "state": "MI",
            "postal_code": "483591598",
            "telephone_number": "248-391-1780",
            "fax_number": "248-391-1862"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLENCZAR",
        "first_name": "MELISSA",
        "middle_name": "ANNE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-18",
        "last_updated": "2020-10-22",
        "certification_date": "2020-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "4301083991",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mklenczar14849@direct.beaumont.edu",
            "affiliation": "N",
            "address_1": "3226 Hidden Timber Dr",
            "address_2": "SUITE A",
            "city": "Lake Orion",
            "state": "MI",
            "country_code": "US",
            "postal_code": "483591598",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "MELISSA",
            "last_name": "KIMBALL",
            "middle_name": "ANNE",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• John David Kilmer, D.O.
• Beth Joy Kimmel, BA,CDF, SST
• Diana Therese Kitzmiller, MA, LLP
• John W Kitzmiller, MD
• Nancy Marie Kizer-Campbell
• Calen Rylea Knight
• Faith Elizabeth Knop
• Sonia Vallieres Koenig, LPC
• James C. Komendera, DDS
• Madison Alyse Koon, PA-C

• Family Medicine Physician in Lake Orion, MI
• Providers in Lake Orion, MI by specialty
• Family Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2020; 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.