Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Kellan Brett Klubben, MD

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1144800905

Kellan Brett Klubben, MD is a Family Practice in Hayward, Wisconsin. Qualified in 2021, 5 years ago. Practices with Advantage Physical Therapy and Sports Rehab, LLC, a 286-clinician group and accepts Medicare assignment. Licensed in Wisconsin.

Years since qualifying
5
Licensed in
WI
In the registry since
2021
Specialties on file
2
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

11040 N State Rd 77
Hayward, WI 54843
Phone: (715) 934-4910
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X · Licence 84153-20 (WI)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1144800905
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedApril 14, 2021
Last updated in NPPESSeptember 11, 2024
Certification dateJune 30, 2021
Mailing address11040 N State Rd 77, Hayward, WI 54843

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyFAMILY PRACTICE
Medical schoolOTHER
Graduated 2021 (5 years in practice)
Group practice Advantage Physical Therapy And Sports Rehab, Llc — 286 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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