Individual provider Active NPI

Glen Alan McClung, MD

  • Sports Medicine (Orthopaedic Surgery) Physician
  • Cincinnati, OH
National Provider Identifier
1467403279
Registry record updated May 4, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Orthopaedic Surgery) PhysicianTaxonomy code 207XX0005X
License
35087210 Issued in OH
Practice address
6480 Harrison Ave
Suite 201
Cincinnati, OH 45247
Phone
(513) 354-3700
Fax
(513) 354-7651
NPI assigned
May 15, 2006
Last updated
May 4, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 4, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X TP803 KY
Sports Medicine (Orthopaedic Surgery) Physician 207XX0005X 35087210 OH Primary

Addresses

Primary practice location

6480 Harrison Ave
Suite 201
Cincinnati, OH 45247

Mailing address

6480 Harrison Ave
Suite 201
Cincinnati, OH 45247-7961
Phone (513) 354-3700

Other practice location 1

6480 Harrison Ave
Suite 201
Cincinnati, OH 45247-7961
Phone (513) 354-3700

Other identifiers 1

IdentifierTypeStateIssuer
64113525MedicaidKY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY, OH2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20050802000083 KY Practitioner - Orthopedic Surgery 4789654245 Reassigns benefits to 1 organization
I20110725000241 OH Practitioner - Orthopedic Surgery 4789654245 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
West Virginia University School of Medicine, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

600 Rodeo Dr
Erlanger, KY 41018-1279
Phone (513) 354-3700

6480 Harrison Ave
Cincinnati, OH 45247-7821
Phone (513) 354-3700

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
93.01 of 100Reported as apm
Quality
86.02
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Lower limb (leg) arthroscopy (minimally invasive joint repair)13
Upper limb (arm) arthroscopy (minimally invasive joint repair)30

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
TP803KYMDOrthopaedic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Beacon Orthopaedics & Sports Medicine, LTD CurrentSince Jul 1, 2011 Accepting new patients
Beacon Orthopaedics & Sports Medicine LTD Orthopaedic Surgery CurrentSince Jul 1, 2011 Accepting new patients
Mississippi Sports Medicine & Orthopaedic Center Orthopaedic Surgery Past Accepting new patients

Locations

600 Rodeo Dr
Erlanger, KY 41018
Phone (513) 574-5400

463 Ohio Pike
Cincinnati, OH 45255
Phone (513) 528-0107

463 Ohio Pike
Ste 201
Cincinnati, OH 45255
Phone (513) 574-5400

463 Ohio Pike
Ste 203
Cincinnati, OH 45255
Phone (513) 247-4340

500 E Business Way
Ste C
Cincinnati, OH 45241
Phone (513) 389-3666

6480 Harrison Ave
Cincinnati, OH 45247
Phone (513) 251-7827

6480 Harrison Ave
Ste 100
Cincinnati, OH 45247

6480 Harrison Ave
Ste 201
Cincinnati, OH 45247
Phone (513) 354-7650

500 E Business Way
Sharonville, OH 45241
Phone (513) 251-7827

Interoperability endpoints

  • Direct secure messaging: glen.mcclung.p1@direct.beaconortho.nextgenshare.com
  • Direct secure messaging: glen.mcclung.p2@direct.beaconortho.nextgenshare.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 9

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": "1147651200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651622400000",
    "number": "1467403279",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6480 HARRISON AVE",
            "address_2": "SUITE 201",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452477961",
            "telephone_number": "513-354-3700",
            "fax_number": "513-354-7651"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6480 HARRISON AVE",
            "address_2": "SUITE 201",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "45247",
            "telephone_number": "513-354-3700",
            "fax_number": "513-354-7651"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6480 Harrison Ave",
            "address_2": "Suite 201",
            "address_purpose": "LOCATION",
            "city": "Cincinnati",
            "state": "OH",
            "postal_code": "452477961",
            "country_code": "US",
            "telephone_number": "513-354-3700",
            "fax_number": "513-354-7651",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCCLUNG",
        "first_name": "GLEN",
        "middle_name": "ALAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-15",
        "last_updated": "2022-05-04",
        "certification_date": "2022-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "KY",
            "license": "TP803",
            "primary": false
        },
        {
            "code": "207XX0005X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": "OH",
            "license": "35087210",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64113525",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cincinnati, OH

Sources for this page

Verify at the official NPI Registry.