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MR. JACK H KLIE MD
NPI 1992876080
Internal Medicine - Cardiovascular Disease in Providence, RI

Active since November 13, 2006PECOS EnrolledAccepts Medicare Assignment
1 RANDALL SQ, SUITE 305, PROVIDENCE, RI 02904(401) 521-0700(401) 521-0906 Get Directions Write a Review

NPPES record last updated: March 13, 2009. Verified against the NPPES registry weekly; last sync: August 23, 2026.

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

NPI1992876080
Entity TypeIndividualMale
Primary Taxonomy207RC0000X
Provider Legal NameMR. JACK H KLIECredential: MD
Location Address1 RANDALL SQ, SUITE 305Providence, RI 02904-2709
Mailing Address1 Randall Sq, Suite 305Providence, RI 02904-2709 · (401) 521-0700 · Fax (401) 521-0906
Phone(401) 521-0700
Fax(401) 521-0906
Sole ProprietorNo
Medical School CMSTufts University School Of MedicineGraduated 1966
Enumeration DateNovember 13, 2006
Last NPPES UpdateMarch 13, 2009
✔ NPI 1992876080 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · Cardiovascular DiseaseAllopathic & Osteopathic Physicians
Taxonomy Code207RC0000X
License✔ Licensed in RI · 4568
Definition
An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms.
1 RANDALL SQ, Providence, RI 02904
Open in Google Maps ↗

Other Identifiers 5

Medicaid9000849RI
Medicare PIN007004497RI
Other849RI · Blue Cross
Other001218RI · Blue Chip
Medicare UPINC90497RI

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

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.

PECOS PAC ID6002718004
PECOS Enrollment IDI20100812000651
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.

Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report only 93010
A routine electrocardiogram (ECG) with 12 leads is a simple, non-invasive test that records the electrical activity of your heart. It helps in identifying heart conditions by detecting irregularities in your heart rhythms. The results are interpreted and a report is provided.
290 services249 patients
Ultrasound of heart with color-depicted blood flow, rate, direction and valve function 93306
This is a heart ultrasound, also known as an echocardiogram. It uses sound waves to create pictures of your heart, showing how blood flows through it. The color depicts the blood flow's speed and direction. It also checks the heart's valves to ensure they're working properly.
30 services30 patients

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, RI
3/5 CMS rating
OwnershipProprietary
CMS Certification Number410005
Location200 High Service AvenueNorth Providence, RI 02904 · Providence County
Emergency services

Physician 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.

New Patient
$134.17 typical visit price
range $58.57 – $177.03
Typical copayment $33.54 (range $14.64 – $44.25)
Most-billed visit code 99204
Established Patient
$72.93 typical visit price
range $18.92 – $144.38
Typical copayment $18.23 (range $4.73 – $36.09)
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.

PHINA A MAYU NP
Nurse Practitioner (Adult Health)
1 RANDALL SQ
PROVIDENCE, RI 02904
Providence County (401) 274-6339
MAYELIN PACHECO NUNEZ NP
Nurse Practitioner (Family)
1 RANDALL SQ
PROVIDENCE, RI 02904
Providence County (401) 274-6339
STANLEY H. BLOCK MD
Allergy & Immunology
1 RANDALL SQ
PROVIDENCE, RI 02904
Providence County (401) 444-0414
DR. JAMES J YASHAR M.D
Specialist
1 RANDALL SQ
PROVIDENCE, RI 02904
Providence County (140) 196-5777
THE PROVIDENCE COMMUNITY HEALTH CENTERS, INC
Clinic/Center (Federally Qualified Health Center (FQHC))
1 RANDALL SQ
PROVIDENCE, RI 02904
Providence County (401) 274-6339
PAUL W WEHBE MD
Pediatrics
1 RANDALL SQ, SUITE 404-406
PROVIDENCE, RI 02904
Providence County (401) 861-5183
CARDIOLOGY CONSULTANTS, LLC
Internal Medicine (Cardiovascular Disease)
1 RANDALL SQ, SUITE 305
PROVIDENCE, RI 02904
Providence County (401) 223-0223
COURTNEY HUNT NP
Nurse Practitioner (Family)
1 RANDALL SQ
PROVIDENCE, RI 02904
Providence County (401) 274-6339

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.

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.