MR. JACK H KLIE MD
NPI 1992876080
Internal Medicine - Cardiovascular Disease in Providence, RI
About Mr. Jack H Klie Md NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
MR. JACK H KLIE MD (NPI 1992876080) is an individual cardiovascular disease provider in Providence, Rhode Island, licensed in Rhode Island (4568) and active in the NPI registry since November 2006. He is enrolled in Medicare PECOS, is affiliated with Our Lady Of Fatima Hospital, and is a graduate of Tufts University School Of Medicine (1966).
NPPES Registry Identity
Specialties & Licenses
Other Identifiers 5
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Mr. Jack H Klie Md 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.
Medicare Billing Reassignments
2Medicare enrollment records show Jack Klie reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Providence, RI 02904
- Reassigned Medicare billing, Rhode Island enrollment
North Providence, RI 02904
- Reassigned Medicare billing, Rhode Island enrollment
- 12 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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.
Hospital Affiliations CMS Care Compare
Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.
Our Lady Of Fatima Hospital
Acute Care Hospitals · North Providence, RIPhysician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 02904 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
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.
PROVIDENCE, RI 02904
PROVIDENCE, RI 02904
PROVIDENCE, RI 02904
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Jack Klie's NPI number?
The NPI number for Jack Klie is 1992876080. It was assigned to this individual provider in the NPPES registry on November 13, 2006.
Where is Jack Klie located?
Jack Klie practices at 1 Randall Sq Suite 305, Providence, RI 02904. The listed phone number is (401) 521-0700.
What is Jack Klie's specialty?
The primary specialty registered for this NPI is Internal Medicine, specializing in Cardiovascular Disease, with taxonomy code 207RC0000X.
Is Jack Klie enrolled in Medicare?
Yes. Jack Klie is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.
Which organizations bill Medicare for Jack Klie's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Jack Klie reassigns Medicare benefits to 2 organizations: Providence Cardiology Inc (Providence, RI) and Prospect Chartercare Sjhsri, LLC (North Providence, RI). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Jack Klie's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
Is Jack Klie affiliated with any hospitals?
According to CMS data, Jack Klie is affiliated with Our Lady Of Fatima Hospital.
When was this NPI record last updated?
The NPPES record for Jack Klie was last updated on March 13, 2009. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 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.
# Mr. Jack H Klie, MD · NPI 1992876080
Cardiovascular Disease physician in Providence, Rhode Island. Individual provider, active in the CMS NPPES registry since November 13, 2006.
## Identity
- **NPI:** 1992876080 (Entity type: Individual)
- **Enumerated:** November 13, 2006
- **Primary specialty:** Internal Medicine - Cardiovascular Disease · taxonomy 207RC0000X
- **State license:** 4568 (Rhode Island)
- **Sole proprietor:** No
## Practice location
- **Address:** 1 RANDALL SQ, SUITE 305, Providence, RI 02904-2709
- **Phone:** (401) 521-0700 · **Fax:** (401) 521-0906
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** 2 organizations under Medicare reassignment (form CMS-855R): Providence Cardiology Inc (NPI 1790856888, Providence, RI); Prospect Chartercare Sjhsri, LLC (NPI 1578988572, North Providence, RI) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Tufts University School Of Medicine, class of 1966
## Record status
- **NPPES last updated:** March 13, 2009
- **Other identifiers:** Medicaid 9000849 (RI); Medicare PIN 007004497 (RI); Other 849 (RI); and 2 more
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Source: [NPI Profile](https://npiprofile.com/npi/1992876080) · Data from the CMS NPPES public registry.