Jack H Klie (NPI# 1992876080, PAC ID# 6002718004) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is CARDIOVASCULAR DISEASE (CARDIOLOGY).
| Nation Provider ID (NPI) | 1992876080 |
| PAC ID by PECOS | 6002718004 |
| Professional Enrollment ID | I20100812000651 |
| Full Name | Jack H Klie |
| Address |
1 Randall Sq Providence RI 02904-2709 |
| Gender | M |
| Medical School | TUFTS UNIVERSITY SCHOOL OF MEDICINE |
| Graduation Year | 1966 |
| Primary Specialty | CARDIOVASCULAR DISEASE (CARDIOLOGY) |
| Secondary Specialties | INTERNAL MEDICINE |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 410005 | OUR LADY OF FATIMA HOSPITAL |
| 410012 | THE MIRIAM HOSPITAL |
| 410004 | ROGER WILLIAMS MEDICAL CENTER |
| Address | Phone | Organization |
|---|---|---|
| 200 High Service Ave, Fatima Hospital Cardiology Group, North Providence, RI 02904-5113 | 4014563166 | PROSPECT CHARTERCARE SJHSRI, LLC |
| 1 Randall Sq, Providence, RI 02904-2709 |
| Measure Identifier | Measure Title | Performance Rate | Reporting Mechanism |
|---|---|---|---|
| MIPS_EC_006_overall | Coronary Artery Disease (CAD): Antiplatelet Therapy | 100% |
| Street Address |
1 RANDALL SQ |
| City | PROVIDENCE |
| State | RI |
| Zip | 02904-2709 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Phina A Mayu | Nurse Practitioner | The Providence Community Health Centers Inc. | 1 Randall Sq, Providence, RI 02904-2709 |
| Richard Watson | Ophthalmology | Massachusetts Eye and Ear Associates, Inc | 1 Randall Sq, Suite 203, Providence, RI 02904-2773 |
| Kely C Jeronimo | Physician Assistant | Rhode Island Medical Imaging | 1 Randall Sq, Providence, RI 02904-2709 |
| Gayge J Maggio | Nurse Practitioner | The Providence Community Health Centers Inc. | 1 Randall Sq, Providence, RI 02904-2709 |
| Jennifer J Raney | Family Medicine | The Providence Community Health Centers Inc. | 1 Randall Sq, Providence, RI 02904-2709 |
| John Paul A Abroguena | Family Medicine | The Providence Community Health Centers Inc. | 1 Randall Sq, Providence, RI 02904-2709 |
| Janelle M Bosse | Physician Assistant | Rhode Island Medical Imaging | 1 Randall Sq, Providence, RI 02904-2709 |
| Courtney L Jusino | Nurse Practitioner | The Providence Community Health Centers Inc. | 1 Randall Sq, Providence, RI 02904-2709 |
| Cynthia B Stewart | Nurse Practitioner | The Providence Community Health Centers Inc. | 1 Randall Sq, Providence, RI 02904-2709 |
| Ethan Prince | Diagnostic Radiology | Rhode Island Medical Imaging | 1 Randall Sq, Providence, RI 02904-2709 |
| Find all physicians in the same address | |||
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Robert B Patterson | Vascular Surgery | 486 Silver Spring St, Providence, RI 02904-1556 | |
| Nishit Shah | Colorectal Surgery (proctology) | University Surgical Associates, Inc. | 208 Collyer St, Suite 302, Providence, RI 02904-1560 |
| Laurel A Gay | Physician Assistant | The Miriam Hospital | 208 Collyer St, Suite 100, Providence, RI 02904-1560 |
| Adam Klipfel | Colorectal Surgery (proctology) | University Surgical Associates, Inc. | 208 Collyer St, Suite 302, Providence, RI 02904-1560 |
| Fredric V Christian | Cardiovascular Disease (cardiology) | The Miriam Hospital | 208 Collyer St, Suite 100, Providence, RI 02904-1560 |
| Roger D Raymond | Cardiovascular Disease (cardiology) | The Miriam Hospital | 208 Collyer St, Suite 100, Providence, RI 02904-1560 |
| Michelle Kristen Finkelman | Nurse Practitioner | The Miriam Hospital | 208 Collyer St, Suite 100, Providence, RI 02904-1560 |
| Olivia Macaskill | Nurse Practitioner | The Miriam Hospital | 208 Collyer St, Suite 100, Providence, RI 02904-1560 |
| Susan P Emaus | Physician Assistant | The Miriam Hospital | 208 Collyer St, Suite 100, Providence, RI 02904-1560 |
| Kenneth S Korr | Cardiovascular Disease (cardiology) | The Miriam Hospital | 208 Collyer St, Providence, RI 02904-1560 |
| Find all physicians in zip 02904 | |||
| City | PROVIDENCE |
| Zip Code | 02904 |
| Specialty | CARDIOVASCULAR DISEASE (CARDIOLOGY) |
| City + Specialty | PROVIDENCE + CARDIOVASCULAR DISEASE (CARDIOLOGY) |
Please comment or provide details below to improve the information on Jack H Klie.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.