NPIMap

Individual provider Active NPI

Albert A. McClain Jr., M. D.

  • Otolaryngology Physician
  • Watertown, NY
National Provider Identifier
1811006786
Registry record updated Jul 5, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
288937 Issued in NY
Practice address
830 Washington St
Watertown, NY 13601-4034
Phone
(315) 786-4824
Fax
(315) 786-4915
NPI assigned
Aug 30, 2006
Last updated
Jul 5, 2017By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 5, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X G71625 CA
Otolaryngology Physician 207Y00000X 288937 NY Primary

Addresses

Primary practice location

830 Washington St
Watertown, NY 13601-4034

Mailing address

578 Reisling Terrace
Chula Vista, CA 91913
Phone (619) 267-8440

Other identifiers 1

IdentifierTypeStateIssuer
00G716250MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050429000300 CA Practitioner - Otolaryngology 8325087257 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
University of California, San Francisco School of Medicine, 1989
Medicare assignment
May accept Medicare assignment
Group practices
Sutter Coast HospitalGroup PAC ID 9436148111, 29 clinicians

Practice addresses (Care Compare)

780 E Washington Blvd
Crescent City, CA 95531-8397
Phone (707) 464-6715

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
82.99 of 100Reported as group
Quality
57.99
Promoting interoperability
100
Improvement activities
40
Cost
72.95

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G71625CAMDOtolaryngology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sutter Coast Hospital CurrentSince Jun 1, 2020 Accepting new patients
Scripps Health Current Accepting new patients
Sutter Coast Hospital CurrentSince Jun 1, 2020 Accepting new patients

Locations

780 E Washington Blvd
Crescent City, CA 95531
Phone (707) 464-5974

800 E Washington Blvd
Crescent City, CA 95531
Phone (707) 464-8511

Interoperability endpoints

  • Direct secure messaging: amcclain545300@hisp.ehr.sutterhealth.org
  • Direct secure messaging: amcclain81319@scrippshlth.medalliesdirect.net

Organizations & group practices 4

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 5

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": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1499212800000",
    "number": "1811006786",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "578 REISLING TERRACE",
            "city": "CHULA VISTA",
            "state": "CA",
            "postal_code": "91913",
            "telephone_number": "619-267-8440",
            "fax_number": "877-795-8215"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "830 WASHINGTON ST",
            "city": "WATERTOWN",
            "state": "NY",
            "postal_code": "136014034",
            "telephone_number": "315-786-4824",
            "fax_number": "315-786-4915"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCLAIN",
        "first_name": "ALBERT",
        "middle_name": "A.",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "M. D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-30",
        "last_updated": "2017-07-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "CA",
            "license": "G71625",
            "primary": false
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "NY",
            "license": "288937",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G716250",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Watertown, NY

Sources for this page

Verify at the official NPI Registry.