EVELINE RUSDIANTO KLENOTIC DO, FACS
NPI 1801185541
Surgery in Canton, OH

Q: What is Eveline Klenotic's NPI number?

The NPI number for Eveline Klenotic is 1801185541. It was assigned to this individual provider in the NPPES registry on April 4, 2011. The provider is also known as Eveline Rusdianto.

Q: What is Eveline Klenotic's specialty?

The primary specialty registered for this NPI is Surgery with taxonomy code 208600000X.

Q: When was this NPI record last updated?

The NPPES record for Eveline Klenotic was last updated on July 19, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years 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 April 04, 2011PECOS EnrolledAccepts Medicare Assignment

2600 SIXTH ST SW, CANTON, OH 44710(330) 344-6000 Get Directions Write a Review

NPPES record last updated: July 19, 2023. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jul 19, 2023, Aug 23, 2022, Feb 26, 2021 and 2 more (5 updates tracked since 2016).

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About Eveline Rusdianto Klenotic Do, Facs NPPES

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

EVELINE RUSDIANTO KLENOTIC DO, FACS (NPI 1801185541) is an individual surgery provider in Canton, Ohio, licensed in Ohio (34.011721) and active in the NPI registry since April 2011. She is enrolled in Medicare PECOS, is affiliated with Summa Health System, and maintains a secondary practice location in Little Rock.

NPPES Registry Identity

NPI1801185541

Entity TypeIndividualFemale

Primary Taxonomy208600000X

Provider Legal NameEVELINE RUSDIANTO KLENOTICCredential: DO, FACS

Location Address2600 SIXTH ST SWCanton, OH 44710-1702

Mailing AddressPo Box 80690Canton, OH 44708-0690 · (330) 363-7444 · Fax (330) 363-7770

Phone(330) 344-6000

Sole ProprietorNo

Medical School CMSDes Moines University Of Osteopathic Medicine And Health SciencesGraduated 2011

Enumeration DateApril 4, 2011

Last NPPES UpdateJuly 19, 20235 updates tracked since enumeration

NPPES CertifiedJuly 19, 2023

✔ NPI 1801185541 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtySurgeryAllopathic & Osteopathic Physicians

Taxonomy Code208600000X

Licenses✔ Licensed in OH · 34.011721✔ Licensed in AR · E-15091

Definition

A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery.

Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X

2600 SIXTH ST SW, Canton, OH 44710

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Other Names 1

Former Name (1)Eveline Rusdianto

Secondary Practice Location 1

Location 14301 W Markham St # 725Little Rock, AR 72205-7101 · Phone (501) 296-1200 · Fax (501) 686-8551

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include MedMutual, UnitedHealthcare.Insurance ›

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

Eveline Rusdianto Klenotic Do, Facs 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 ID446548093

PECOS Enrollment IDI20161013001706

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.

Areas of Expertise CMS Part B claims 2

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Prolonged office or other outpatient evaluation and management service(s) beyond the maximum required time of the primary procedure which has been selected using total time on the date of the primary service; each additional 15 minutes by the physician or G2212

This service refers to extended doctor visits where your healthcare provider spends additional time evaluating and managing your health beyond the primary procedure's required time. This includes each extra 15 minutes spent by the physician on the same day as the primary service.

23 services12 patients

New patient office or other outpatient visit with a high level of medical decision making, if using time, 60 minutes or more 99205

This is a first-time patient visit where a healthcare professional spends 60-74 minutes with you. It involves a comprehensive evaluation, including your medical history and current health condition. They'll also advise on preventive health measures and formulate a treatment plan if needed.

12 services12 patients

Hospital Affiliations CMS Care Compare 2

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Summa Health System

Acute Care Hospitals · Akron, OH

2/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number360020

Location525 East Market StreetAkron, OH 44309 · Summit County

Emergency services Birthing friendly

Aultman Hospital

Acute Care Hospitals · Canton, OH

4/5 CMS rating

OwnershipVoluntary non-profit - Other

CMS Certification Number360084

Location2600 Sixth Street SWCanton, OH 44710 · Stark County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 44710 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$84.72 typical visit price

range $54.34 – $166.65

Typical copayment $21.18 (range $13.58 – $41.66)

Most-billed visit code 99203

Established Patient

$68.07 typical visit price

range $17.10 – $135.40

Typical copayment $17.01 (range $4.27 – $33.85)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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.

CHELSEA FLIGHT CNP

Nurse Practitioner