Mr Jack H Klie, MD - Medicare Cardiovascular Disease (cardiology) in Providence, RI

Mr Jack H Klie, MD is a medicare enrolled "Internal Medicine - Cardiovascular Disease" physician in Providence, Rhode Island. He went to Tufts University School Of Medicine and graduated in 1966 and has 58 years of diverse experience with area of expertise as Cardiovascular Disease (cardiology). He is a member of the group practice Prospect Chartercare Sjhsri Llc and his current practice location is 1 Randall Sq, Suite 305, Providence, Rhode Island. You can reach out to his office (for appointments etc.) via phone at (401) 521-0700.

Mr Jack H Klie is licensed to practice in Rhode Island (license number 4568) and he also participates in the medicare program. He accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1992876080.

Contact Information

Mr Jack H Klie, MD
1 Randall Sq, Suite 305,
Providence, RI 02904-2709
(401) 521-0700
(401) 521-0906



Physician's Profile

Full NameMr Jack H Klie
GenderMale
SpecialityCardiovascular Disease (cardiology)
Experience58 Years
Location1 Randall Sq, Providence, Rhode Island
Accepts Medicare AssignmentsYes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.
  Medical Education and Training:
  • Mr Jack H Klie attended and graduated from Tufts University School Of Medicine in 1966
  NPI Data:
  • NPI Number: 1992876080
  • Provider Enumeration Date: 11/13/2006
  • Last Update Date: 03/13/2009
  Medicare PECOS Information:
  • PECOS PAC ID: 6002718004
  • Enrollment ID: I20100812000651

Medical Identifiers

Medical identifiers for Mr Jack H Klie such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1992876080NPI-NPPES
849OtherRIBLUE CROSS
9000849MedicaidRI
001218OtherRIBLUE CHIP

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
207RC0000XInternal Medicine - Cardiovascular Disease 4568 (Rhode Island)Primary

Medical Facilities Affiliation

Facility NameLocationFacility Type
Our Lady Of Fatima HospitalNorth providence, RIHospital

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Mr Jack H Klie allows following entities to bill medicare on his behalf.
Entity NameProvidence Cardiology Inc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1790856888
PECOS PAC ID: 6800958166
Enrollment ID: O20081219000341

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› Verified 6 days ago

Entity NameProspect Chartercare Sjhsri Llc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1578988572
PECOS PAC ID: 7315179314
Enrollment ID: O20140721001270

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Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mr Jack H Klie is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Mr Jack H Klie, MD
1 Randall Sq, Suite 305,
Providence, RI 02904-2709

Ph: (401) 521-0700
Mr Jack H Klie, MD
1 Randall Sq, Suite 305,
Providence, RI 02904-2709

Ph: (401) 521-0700

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Internal Medicine Doctors in Providence, RI

Christopher Donald Palmer, DO
Cardiovascular Disease
Medicare: Accepting Medicare Assignments
Practice Location: 101 Dudley St, Providence, RI 02905
Phone: 401-274-1122    Fax: 401-453-7597
Martha Catherine Trimbur, MD
Cardiovascular Disease
Medicare: Accepting Medicare Assignments
Practice Location: 245 Chapman St Ste 300, Providence, RI 02905
Phone: 401-444-4741    Fax: 401-444-4445
Karl Herman, M.D.
Cardiovascular Disease
Medicare: Accepting Medicare Assignments
Practice Location: 164 Summit Ave, Fain Bldg., Providence, RI 02906
Phone: 401-793-4489    Fax: 401-793-4047
Muhammad Baig, M.D.
Cardiovascular Disease
Medicare: Accepting Medicare Assignments
Practice Location: 164 Summit Ave, Fain Bldg, Providence, RI 02906
Phone: 401-793-4489    Fax: 401-793-4047
Dr. Peter Sidhom, DO
Cardiovascular Disease
Medicare: Accepting Medicare Assignments
Practice Location: 825 Chalkstone Ave, Providence, RI 02908
Phone: 603-560-2276    
Dr. Kanhai Farrakhan, MD
Cardiovascular Disease
Medicare: Medicare Enrolled
Practice Location: 593 Eddy St, Providence, RI 02903
Phone: 401-457-3336    Fax: 401-525-2349
Gary M Katzman, MD
Cardiovascular Disease
Medicare: Accepting Medicare Assignments
Practice Location: 208 Collyer Street, Suite 100, Providence, RI 02904
Phone: 401-793-7191    Fax: 401-793-7200

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