DIANE FLETCHER KLOS (PT) – Physical Therapist, NPI 1609871508

DIANE FLETCHER KLOS (PT) is a healthcare provider. based in La crosse, Wisconsin. specializing in PHYSICAL THERAPIST IN PRIVATE PRACTICE. They hold the professional credentials PT. They hold a License No. 3100 (WI). The NPI Number for DIANE FLETCHER KLOS (PT) is 1609871508

Main info

Female
41 Years Of Experience
Accepts Medicare Assignment
Name
DIANE FLETCHER KLOS (PT)
NPI
1609871508
Phone
(608) 782-7300
Address
1836 SOUTH AVE
Enumeration Date
16 June 2005
Last Update Date
29 September 2009

Doctor Profile

Medical School Name
OTHER
Secondary Phone
6083513049
Graduation Year
1985 (41 years ago)
PAC ID
5193626422
Group Practice PAC ID
3779948302
Professional Enrollment ID
I20040119000528
Address ID
WI546502835ON1430XSTXX300
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience54
Completeness75
Years active:20State licenses:1Digital endpointsOther names

1,990 PHYSICAL THERAPIST IN PRIVATE PRACTICE in WI

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Provider Addresses for DIANE FLETCHER KLOS (PT)

  • South Avenue, La Crosse, La Crosse County, Wisconsin, 54601, United States

    LA CROSSE, WI 546015429

    Phone: (608) 782-7300

    Mailing address matches the actual address.

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: 2004-01-19

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20040119000528IPhysical Therapist In Private PracticeWITBD

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.

Verify on CMS Revalidation Lookup Tool

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 54601)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 3779948302View full group profile
NameSpecialtyState
Physical Therapist In Private PracticeWI
Physical Therapist In Private PracticeWI
Physical Therapist In Private PracticeWI
Physical Therapist In Private PracticeWI
Physical Therapist In Private PracticeWI
Physical Therapist In Private PracticeMO

Reviews

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Frequently asked questions

Is there an official ID for DIANE FLETCHER KLOS (PT) in U.S. healthcare records?
The official identifier for DIANE FLETCHER KLOS (PT) is NPI 1609871508.
Would DIANE FLETCHER KLOS (PT) appear as active to a payer?
You can treat DIANE FLETCHER KLOS (PT) as active for directory purposes; confirm clinical privileges separately.
How would a patient describe DIANE FLETCHER KLOS (PT)'s focus?
For DIANE FLETCHER KLOS (PT), the primary taxonomy reads as Physical Therapist. Clinical services aligned with this taxonomy classification.
Is DIANE FLETCHER KLOS (PT) located near La Crosse?
DIANE FLETCHER KLOS (PT) currently maps to La Crosse, Wisconsin in this extract.
Does inactive status remove historical data?
Historical rows can remain visible after status changes — read the dates carefully.

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