MR. THEODORE CARROLL KLEM (M.D.) – Internal Medicine Physician, NPI 1063702876
Internal Medicine Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
916 INTERNAL MEDICINE in ME
Provider Addresses for MR. THEODORE CARROLL KLEM (M.D.)
PO BOX 844658
DALLAS, TX 752844658
Phone: (254) 724-2111
Fax: (254) 724-7603
Type: Mailing
35 MEDICAL CENTER PKWY
AUGUSTA, ME 043308160
Phone: (207) 626-1000
Type: Location
9433 BEE CAVES RD
BUILDING 3, SUITE 103
AUSTIN, TX 78733
Phone: (512) 649-7515
Fax: (512) 649-1913
Type: Mailing
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: 2018-06-14
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 |
|---|---|---|---|---|
| I20140916000061 | I | Internal Medicine | TX | TBD |
| I20180614000361 | I | Hospitalist | ME | 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.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 99223 | Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes | 13 | 13 | $0 |
Insurance plans in this area (ZIP 75284)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| - | TX | |
| R H E U M A T O L O G Y | TX | |
| E N D O C R I N O L O G Y | TX | |
| Family Practice | TX | |
| Internal Medicine, Hospitalist | TX | |
| Nurse Practitioner | TX | |
| Physician Assistant | TX | |
| Internal Medicine | TX | |
| Internal Medicine, Hospitalist | TX | |
| - | TX |
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