Clinton Runnells McLean, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

904 Issued in CT

Practice address

880 Bridgeport Ave
Shelton, CT 06484-4625

Phone

(203) 929-4030

Fax

(203) 929-9662

NPI assigned

Sep 21, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 5

Medicare fee-for-service enrollment

Enrolled in CT

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Optometry

Education

New England College of Optometry, 1979

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Waterbury Eye Associates LLCGroup PAC ID 9931223849, 3 clinicians

Vision Center, LTDGroup PAC ID 9032138938, 4 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Vision Center, LTD

  • Optometrist
  • Shelton, CT
  • NPI 1598805871
  Medicare reassignment Care Compare group NPD Authorized official
• Waterbury Eye Associates LLC

  • Optometrist
  • Waterbury, CT
  • NPI 1750403051
  Medicare reassignment Care Compare group NPD Authorized official

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

{
    "created_epoch": "1158796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1801995543",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "880 BRIDGEPORT AVE",
            "city": "SHELTON",
            "state": "CT",
            "postal_code": "064844625",
            "telephone_number": "203-929-4030",
            "fax_number": "203-929-9662"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "880 BRIDGEPORT AVE",
            "city": "SHELTON",
            "state": "CT",
            "postal_code": "064844625",
            "telephone_number": "203-929-4030",
            "fax_number": "203-929-9662"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCLEAN",
        "first_name": "CLINTON",
        "middle_name": "RUNNELLS",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CT",
            "license": "904",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BCBS",
            "identifier": "090000904CT01",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CONNECTICARE",
            "identifier": "904000-4749",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "4271642",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE DMERC SUPPLIER",
            "identifier": "0248660001",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD HEALTH PLAN",
            "identifier": "P606621",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tiara L McDuffie
• Maureen McGowan Schwartz, APRN
• Susan Jean McGowan, LMFT
• Latavia Natalia McKenzie, BT
• Coleen May McLaughlin, PA-C
• Keniel O. McLennon, OTR/L
• John McWeeney, LCSW
• Meaningful Connexions Therapy LLC
• Medi-Ssage
• Medical Anesthesiology Associates P.C

• Optometrist in Shelton, CT
• Providers in Shelton, CT by specialty
• Optometrist in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.