Individual provider Active NPI

Michael S McClincy, M.D.

  • Family Medicine Physician
  • Charlottesville, VA
National Provider Identifier
1073504130
Registry record updated Aug 28, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
0101271881 Issued in VA
Practice address
630 Peter Jefferson Pkwy Ste 135
Charlottesville, VA 22911-8630
Phone
(434) 307-0268
Fax
(434) 299-3379
NPI assigned
Oct 28, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 0101271881 VA Primary
Family Medicine Physician 207Q00000X 46474 WA

Addresses

Primary practice location

630 Peter Jefferson Pkwy Ste 135
Charlottesville, VA 22911-8630

Mailing address

630 Peter Jefferson Pkwy Ste 135
Charlottesville, VA 22911-8630
Phone (434) 307-0268

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210504001145 VA Practitioner - Family Practice 2668574229 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Uniformed Services Uhs Fe Hebert School of Med, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Martha Jefferson Medical Group LLCGroup PAC ID 5991889081, 197 clinicians
Select Physical Therapy Holdings IncGroup PAC ID 9537076401, shared by 76 NPIs, 1,992 clinicians

Practice addresses (Care Compare)

1646 Park Ridge Dr
Crozet, VA 22932-3155
Phone (434) 654-2760

250 Merchant Walk SQ
Charlottesville, VA 22902-6511
Phone (434) 328-4900

29 Jefferson CT
Zion Crossroads, VA 22942-9602
Phone (434) 654-8900

590 Peter Jefferson Pkwy
Suite 100
Charlottesville, VA 22911-4628
Phone (434) 654-8930

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
46474WAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Martha Jefferson Medical Group LLC Family Medicine CurrentSince Jun 21, 2021 Accepting new patients
Martha Jefferson Hospital Past Accepting new patients

Locations

315 10th St NE
Charlottesville, VA 22902
Phone (434) 654-1950

920 E High St
Ste 201
Charlottesville, VA 22902
Phone (434) 654-1950

1646 Park Ridge Dr
Crozet, VA 22932
Phone (434) 654-2760

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1130457600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787875200000",
    "number": "1073504130",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "630 PETER JEFFERSON PKWY STE 135",
            "city": "CHARLOTTESVILLE",
            "state": "VA",
            "postal_code": "229118630",
            "telephone_number": "434-307-0268",
            "fax_number": "434-299-3379"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "630 PETER JEFFERSON PKWY STE 135",
            "city": "CHARLOTTESVILLE",
            "state": "VA",
            "postal_code": "229118630",
            "telephone_number": "434-307-0268",
            "fax_number": "434-299-3379"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCLINCY",
        "first_name": "MICHAEL",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-28",
        "last_updated": "2026-08-28",
        "certification_date": "2026-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "VA",
            "license": "0101271881",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "46474",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlottesville, VA

Sources for this page

Verify at the official NPI Registry.