Individual provider Active NPI

James Steele McClellan III, MD

  • Allergy Physician
  • Traverse City, MI
National Provider Identifier
1124089073
Registry record updated Mar 14, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Allergy PhysicianTaxonomy code 207KA0200X
License
JM073559 Issued in MI
Practice address
447 Munson Ave
Traverse City, MI 49686-3084
Phone
(231) 929-9090
Fax
(231) 929-9092
NPI assigned
Mar 30, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 14, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Allergy Physician 207KA0200X JM073559 MI Primary

Addresses

Primary practice location

447 Munson Ave
Traverse City, MI 49686-3084

Mailing address

447 Munson Ave
Traverse City, MI 49686-3084
Phone (231) 929-9090

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20071129000650 MI Practitioner - Allergy/Immunology 0840389755 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Allergy/Immunology
Education
St. Louis College of Physicians and Surgeons, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bayside Allergy, P.C.Group PAC ID 4284723198, 4 clinicians

Practice addresses (Care Compare)

447 Munson Ave
Traverse City, MI 49686-3084
Phone (231) 929-9090

Hospital & facility affiliations

  • Munson Healthcare Cadillac Hospital Hospital, Cadillac, MI, CCN 230081
  • Kalkaska Memorial Health Center Hospital, Kalkaska, MI, CCN 231301
  • McLaren Central Michigan Hospital, Mount Pleasant, MI, CCN 230080
  • Mymichigan Medical Center Alpena Hospital, Alpena, MI, CCN 230036
  • Munson Healthcare Otsego Memorial Hospital Hospital, Gaylord, MI, CCN 230133

Procedures performed for Medicare patients

ProcedureNumber of procedures
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
JM073559MIMDAllergy Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Bayside Allergy, P.C. Allergy CurrentSince Oct 25, 2007 Accepting new patients

Locations

617 N Court Ave
Gaylord, MI 49735
Phone (989) 731-9532

1200 W North Down River Rd
Ste C
Grayling, MI 49738
Phone (231) 935-6455

447 Munson Ave
Traverse City, MI 49686

603 Bay St
Traverse City, MI 49684
Phone (616) 941-7050

Interoperability endpoints

  • Direct secure messaging: james.mcclellan@bsal.eclinicaldirectplus.com

Organizations & group practices 1

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 8

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": "1143676800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1363219200000",
    "number": "1124089073",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "447 MUNSON AVE",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496863084",
            "telephone_number": "231-929-9090",
            "fax_number": "231-929-9092"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "447 MUNSON AVE",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496863084",
            "telephone_number": "231-929-9090",
            "fax_number": "231-929-9092"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCLELLAN",
        "first_name": "JAMES",
        "middle_name": "STEELE",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-03-30",
        "last_updated": "2013-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207KA0200X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology, Allergy",
            "state": "MI",
            "license": "JM073559",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Traverse City, MI

Sources for this page

Verify at the official NPI Registry.