Individual provider Active NPI

Marilyn Meade McCluskey, M.D.

  • Specialist
  • Austin, TX
National Provider Identifier
1104907492
Registry record updated Jan 6, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
H5927 Issued in TX
Practice address
11111 Research Blvd
Ste 170
Austin, TX 78759-5264
Phone
(512) 338-5222
Fax
(512) 338-5229
NPI assigned
Oct 17, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 6, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X H5927 TX Primary

Addresses

Primary practice location

11111 Research Blvd
Ste 170
Austin, TX 78759-5264

Mailing address

1701 Meadowbrook Dr
Austin, TX 78703-2840
Phone (512) 345-9476

Other identifiers 1

IdentifierTypeStateIssuer
P08078214MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20110120000826 TX Practitioner - Ophthalmology 5294914453 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
Mississippi Medical College, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Premier Eye Care, PAGroup PAC ID 5890837983, 2 clinicians

Practice addresses (Care Compare)

11111 Research Blvd
Suite 170
Austin, TX 78759-5280
Phone (512) 338-5222

Merit-based Incentive Payment System (MIPS)

Final score
0 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
0

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Premier Eye Care, PA Specialist CurrentSince Sep 28, 1989 Accepting new patients
Eye Physicians of Austin P a Past Accepting new patients

Locations

11111 Research Blvd
Ste 170
Austin, TX 78759
Phone (512) 338-5222

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.

NPI Registry JSON

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

{
    "created_epoch": "1161043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1294272000000",
    "number": "1104907492",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1701 MEADOWBROOK DR",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787032840",
            "telephone_number": "512-345-9476"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11111 RESEARCH BLVD",
            "address_2": "STE 170",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787595264",
            "telephone_number": "512-338-5222",
            "fax_number": "512-338-5229"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCLUSKEY",
        "first_name": "MARILYN",
        "middle_name": "MEADE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-17",
        "last_updated": "2011-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "TX",
            "license": "H5927",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "P08078214",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Austin, TX

Sources for this page

Verify at the official NPI Registry.