MICHAEL KLOSE
NPI 1053717975
Physician Assistant - Medical in Tinker Afb, OK

Q: What is Michael Klose's NPI number?

The NPI number for Michael Klose is 1053717975. It was assigned to this individual provider in the NPPES registry on November 5, 2014.

Q: What is Michael Klose's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Medical, with taxonomy code 363AM0700X.

Q: When was this NPI record last updated?

The NPPES record for Michael Klose was last updated on October 7, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 21 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since November 05, 2014PECOS EnrolledAccepts Medicare Assignment

7050 AIR DEPOT BLVD, TINKER AFB, OK 73145(405) 734-2778(405) 736-3128 Get Directions Write a Review

NPPES record last updated: October 7, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Oct 7, 2024, Jan 23, 2020 (2 updates tracked since 2020).

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About Michael Klose NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MICHAEL KLOSE (NPI 1053717975) is an individual medical provider in Tinker Afb, Oklahoma and active in the NPI registry since November 2014. He is enrolled in Medicare PECOS and is a graduate of Other (2015).

NPPES Registry Identity

NPI1053717975

Entity TypeIndividualMale

Primary Taxonomy363AM0700X

Provider Legal NameMICHAEL KLOSE

Location Address7050 AIR DEPOT BLVDTinker Afb, OK 73145-8716

Mailing Address7050 Air Depot BlvdTinker Afb, OK 73145-8716 · (405) 734-2778 · Fax (405) 736-3128

Phone(405) 734-2778

Fax(405) 736-3128

Sole ProprietorNo

Medical School CMSOtherGraduated 2015

Enumeration DateNovember 5, 2014

Last NPPES UpdateOctober 7, 20242 updates tracked since enumeration

NPPES CertifiedOctober 7, 2024

✔ NPI 1053717975 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPhysician Assistant · MedicalPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363AM0700X

Also ListedPhysician AssistantTaxonomy 363A00000X

7050 AIR DEPOT BLVD, Tinker Afb, OK 73145

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Michael Klose is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID2668942160

PECOS Enrollment IDI20260526002718

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

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Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

PHILLIP JACOB TREXEL

Student in an Organized Health Care Education/Training Program