NPIMap

Individual provider Active NPI

Gregory Dewayne McClain, M.D.

  • Surgery Physician
  • Pueblo, CO
National Provider Identifier
1093763542
Registry record updated Oct 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
DR.0055743 Issued in CO
Practice address
1020 Lakeview Ave
Pueblo, CO 81004-3508
Phone
(719) 557-3777
Fax
(719) 557-3775
NPI assigned
May 5, 2006
Last updated
Oct 4, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 4, 2024

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

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X DR.0055743 CO
Surgery Physician 208600000X 2013025596 MO
Surgery Physician 208600000X ME101924 FL
Surgery Physician 208600000X DR.0055743 CO Primary
Surgery Physician 208600000X 1489-TEP WI
Surgery Physician 208600000X N3408 TX

Addresses

Primary practice location

1020 Lakeview Ave
Pueblo, CO 81004-3508

Mailing address

PO Box 800022
Kansas City, MO 64180-0022
Phone (800) 953-0104

Other practice location 1

200 N John Young Pkwy
Suite 203
Kissimmee, FL 34741-6601
Phone (407) 624-3062

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20181009002532 CO Practitioner - General Surgery 7517035504 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
University of Colorado School of Medicine, Denver, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Catholic Health Initiatives ColoradoGroup PAC ID 8022927342, 1,230 clinicians

Practice addresses (Care Compare)

1020 Lakeview Ave
Pueblo, CO 81004-3508
Phone (719) 557-3777

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
82.25 of 100Reported as group
Quality
94.96
Improvement activities
40
Cost
47.55

Merit-based Incentive Payment System (MIPS)

Final score
89.06 of 100Reported as group
Quality
89.53
Promoting interoperability
100
Improvement activities
40
Cost
74

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Upper gastrointestinal (GI) endoscopy for acid reflux1-10
Removal of tissue1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
DR.0055743COMDInternal Medicine Physician
1489-TEPWIMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Catholic Health Initiatives Colorado CurrentSince Sep 1, 2024 Accepting new patients
Catholic Health Initiatives Colorado Current Accepting new patients
Catholic Health Initiatives Colorado CurrentSince Sep 1, 2024 Accepting new patients
Catholic Health Initiatives Colorado Past Accepting new patients
Catholic Health Initiatives Colorado Past Accepting new patients
Rural Physicians Group-Pannu PLLC Internal Medicine Past Accepting new patients

Locations

9100 E Mineral Cir
Centennial, CO 80112
Phone (303) 561-5193

1020 Lakeview Ave
Pueblo, CO 81004
Phone (719) 557-3145

41 State Highway 67
Woodland Park, CO 80863
Phone (719) 686-0551

Organizations & group practices 6

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

Hospital & facility affiliations 3

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": "1146787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728000000000",
    "number": "1093763542",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 800022",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641800022",
            "telephone_number": "800-953-0104",
            "fax_number": "303-765-6670"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1020 LAKEVIEW AVE",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810043508",
            "telephone_number": "719-557-3777",
            "fax_number": "719-557-3775"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "200 N John Young Pkwy",
            "address_2": "Suite 203",
            "address_purpose": "LOCATION",
            "city": "Kissimmee",
            "state": "FL",
            "postal_code": "347416601",
            "country_code": "US",
            "telephone_number": "407-624-3062",
            "fax_number": "407-613-2223",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCCLAIN",
        "first_name": "GREGORY",
        "middle_name": "DEWAYNE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-05",
        "last_updated": "2024-10-04",
        "certification_date": "2024-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CO",
            "license": "DR.0055743",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MO",
            "license": "2013025596",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "FL",
            "license": "ME101924",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "CO",
            "license": "DR.0055743",
            "primary": true
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "WI",
            "license": "1489-TEP",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "TX",
            "license": "N3408",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pueblo, CO

Sources for this page

Verify at the official NPI Registry.