Omni McCluney, PHYSICIAN ASSISTANT

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA11786 Issued in TX

Practice address

2525 W Bellfort Ave Ste 205
Houston, TX 77054-5000

Phone

(713) 741-3376

NPI assigned

Dec 12, 2013

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Moore Dermatology PLLCGroup PAC ID 8628504628, 2 clinicians

Oliver Street 5.01(a) IncGroup PAC ID 0042464125, 169 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Interoperability endpoints

• Direct secure messaging: omccluney@moorederm.emadirect.md

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.

• Moore Dermatology PLLC

  • Dermatology Physician
  • Houston, TX
  • NPI 1578312054
  Medicare reassignment Care Compare group Authorized official
• Oliver Street 5.01(a) Inc.

  • Dermatology Physician
  • Dallas, TX
  • NPI 1457695413
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1386806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1622764800000",
    "number": "1689005860",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2525 W BELLFORT AVE STE 205",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770545000",
            "telephone_number": "713-741-3376"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2525 W BELLFORT AVE STE 205",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770545000",
            "telephone_number": "713-741-3376"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCLUNEY",
        "first_name": "OMNI",
        "name_prefix": "Ms.",
        "credential": "PHYSICIAN ASSISTANT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-12-12",
        "last_updated": "2021-06-04",
        "certification_date": "2021-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "TX",
            "license": "PA11786",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Angel Eve McClinton, PA-C
• Sharon Syers McCloskey, M.D.
• Daisey M McCloud, MA, LPC
• Samuel Gardner McClugage, M.D.
• Charles W McCluggage, M.D.
• Danny McClung, P.T.
• Douglas Lauren McClung, D.D.S.
• Julie McClung, APRN
• Tony S McClung, MD
• Caitlin Bailey McClure, PH.D., LPC

• Medical Physician Assistant in Houston, TX
• Providers in Houston, TX by specialty
• Medical Physician Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.