Individual provider Active NPI

Michael J. Clune, M.D.

  • Ophthalmology Physician
  • St Clair Shores, MI
National Provider Identifier
1255327490
Registry record updated Sep 11, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
4301054473 Issued in MI
Practice address
25511 Little Mack Ave
Suite a
St Clair Shores, MI 48081-3372
Phone
(586) 774-2020
Fax
(586) 774-3169
NPI assigned
Sep 22, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X 4301054473 MI Primary

Addresses

Primary practice location

25511 Little Mack Ave
Suite a
St Clair Shores, MI 48081-3372

Mailing address

25511 Little Mack Ave
Suite a
St Clair Shores, MI 48081-3372
Phone (586) 774-2020

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
I20040803000907 MI Practitioner - Ophthalmology 8628049038 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
Georgetown University School of Medicine, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Eastside Eye Physicians PCGroup PAC ID 3678560018, 6 clinicians

Practice addresses (Care Compare)

25511 Little Mack Ave
Suite a
Saint Clair Shores, MI 48081-3300
Phone (586) 774-2020

Merit-based Incentive Payment System (MIPS)

Final score
93.34 of 100Reported as group
Quality
89.52
Promoting interoperability
97
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery301
Removal or shaving of skin growth1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Eastside Eye Physicians, PC Ophthalmology CurrentSince Feb 9, 1998 Accepting new patients
Eastside Eye Physicians, PC PastSince Apr 15, 2004 Accepting new patients
Eastside Eye Physicians, PC PastSince Apr 15, 2004 Accepting new patients

Locations

47100 Schoenherr Rd
Ste F
Shelby Township, MI 48315
Phone (586) 247-2020

47100 Schoenherr Rd
Shelby Township, MI 48315
Phone (586) 532-9800

25511 Little Mack Ave
#J
St Clr Shores, MI 48081

25511 Little Mack Ave
St Clr Shores, MI 48081
Phone (586) 774-2020

25511 Little Mack Ave
Ste A
St Clr Shores, MI 48081
Phone (586) 774-2020

Interoperability endpoints

  • Direct secure messaging: mclune1123501@direct.hfhs.org

Organizations & group practices 3

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": "1127347200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1189468800000",
    "number": "1255327490",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25511 LITTLE MACK AVE",
            "address_2": "SUITE A",
            "city": "ST CLAIR SHORES",
            "state": "MI",
            "postal_code": "480813372",
            "telephone_number": "586-774-2020",
            "fax_number": "586-774-3169"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25511 LITTLE MACK AVE",
            "address_2": "SUITE A",
            "city": "ST CLAIR SHORES",
            "state": "MI",
            "postal_code": "480813372",
            "telephone_number": "586-774-2020",
            "fax_number": "586-774-3169"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLUNE",
        "first_name": "MICHAEL",
        "middle_name": "J.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-22",
        "last_updated": "2007-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "MI",
            "license": "4301054473",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St Clair Shores, MI

Sources for this page

Verify at the official NPI Registry.