MR. DAVID A KLOSS (M.D.) – Specialist, NPI 1003842915
Specialist
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for MR. DAVID A KLOSS (M.D.)
415 Jefferson St North
Tri-County Hospital
Wadena, MN 564821296
Phone: (218) 631-3510
Fax: (218) 631-7507
Type: Location
Tri-County Health Care, 415, Jefferson Street North, Wadena, Wadena County, Minnesota, 56482, United States
TRI-COUNTY HOSPITAL
WADENA, MN 564821296
Phone: (218) 631-3510
Fax: (218) 631-7507
Type: Mailing
ThedaCare Medical Center-Shawano, 100, County Road B, Shawano, Town of Waukechon, Shawano County, Wisconsin, 54166, United States
SHAWANO, WI 541667072
Phone: (715) 524-2161
Fax: (715) 524-8164
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2019-06-17
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 2 Medicare enrollment records; no due dates published yet.
Enrollment records
2
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20111028000429 | I | General Surgery | MN | TBD |
| I20190617001015 | I | General Surgery | WI | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 56482)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Diagnostic Radiology | MN | |
| Clinical Social Worker | MN | |
| - | MN | |
| U R O L O G Y | MA | |
| Emergency Medicine | MN | |
| Physician Assistant | MN | |
| - | MN | |
| Nurse Practitioner | MN | |
| Nurse Practitioner | MN | |
| Family Practice | MN |
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