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DR. CARL F CLAVENNA M.D.
NPI 1003812561
Ophthalmology in Birmingham, MI

Active since June 21, 2005PECOS Enrolled
78.03/100
CMS Quality Rating
600 S ADAMS RD, STE 200, BIRMINGHAM, MI 48009(248) 646-3733(248) 642-2566 Get Directions Write a Review

NPPES record last updated: November 17, 2021. Verified against the NPPES registry weekly; last sync: November 01, 2026.

About Dr. Carl F Clavenna M.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. CARL F CLAVENNA M.D. (NPI 1003812561) is an individual ophthalmology provider in Birmingham, Michigan, licensed in Michigan (4301054362) and active in the NPI registry since June 2005. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1003812561
Entity TypeIndividualMale
Primary Taxonomy207W00000X
Provider Legal NameDR. CARL F CLAVENNACredential: M.D.
Location Address600 S ADAMS RD, STE 200Birmingham, MI 48009-6863
Mailing Address600 S Adams Rd, Ste 200Birmingham, MI 48009-6863 · (248) 646-3733 · Fax (248) 642-2566
Phone(248) 646-3733
Fax(248) 642-2566
Sole ProprietorNo
Enumeration DateJune 21, 2005
Last NPPES UpdateNovember 17, 2021
NPPES CertifiedNovember 17, 2021
✔ NPI 1003812561 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOphthalmologyAllopathic & Osteopathic Physicians
Taxonomy Code207W00000X
License✔ Licensed in MI · 4301054362
Definition
An ophthalmologist has the knowledge and professional skills needed to provide comprehensive eye and vision care. Ophthalmologists are medically trained to diagnose, monitor and medically or surgically treat all ocular and visual disorders. This includes problems affecting the eye and its component structures, the eyelids, the orbit and the visual pathways. In so doing, an ophthalmologist prescribes vision services, including glasses and contact lenses.
600 S ADAMS RD, Birmingham, MI 48009
Open in Google Maps ↗

Other Identifiers 6

OtherC4110MI · M-care Id #
OtherF48420MI · Hap Pin #
OtherF48420MI · Ppom
Other180F321870MI · Blue Cross Group Number
Other101441MI · Care Choices Pin
OtherG5031FMI · Blue Care Network Group #

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter from Meridian, Ambetter Health and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Carl F Clavenna M.d. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Carl Clavenna reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Beaumont Medical Group- Specialty Services
2.3 mi
Surgery
3601 W 13 MILE RD
Royal Oak, MI 48073
  • Reassigned Medicare billing, Michigan enrollment
  • 1,030 clinicians in this Medicare group
NPI 1578072906 (248) 898-5000

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 48009 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$134.28 typical visit price
range $58.04 – $177.36
Typical copayment $33.57 (range $14.51 – $44.34)
Most-billed visit code 99204
Established Patient
$72.38 typical visit price
range $18.32 – $143.49
Typical copayment $18.09 (range $4.58 – $35.87)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

78.03/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality97.47
Promoting Interoperability99
Improvement Activities40
Cost30.12

Reported Quality Measures

Diabetes: Eye Exam
Percentage of patients 18-75 years of age with diabetes who had a retinal or dilated eye exam by an eye care professional during the measurement period or a negative retinal exam (no evidence of retinopathy) in the 12 months prior to the measurement period
97%118 patients4/55-star benchmark: 100%
Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

CARL F. CLAVENNA, M.D., P.C.
Ophthalmology
600 S ADAMS RD, SUITE 200
BIRMINGHAM, MI 48009
Oakland County (248) 646-3733
GREGORY BERNARD FITZGERALD M.D.
Ophthalmology
600 S ADAMS RD, STE 200
BIRMINGHAM, MI 48009
Oakland County (248) 646-3733

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Carl Clavenna's NPI number?

The NPI number for Carl Clavenna is 1003812561. It was assigned to this individual provider in the NPPES registry on June 21, 2005.

Where is Carl Clavenna located?

Carl Clavenna practices at 600 S Adams Rd Ste 200, Birmingham, MI 48009. The listed phone number is (248) 646-3733.

What is Carl Clavenna's specialty?

The primary specialty registered for this NPI is Ophthalmology with taxonomy code 207W00000X.

Is Carl Clavenna enrolled in Medicare?

Yes. Carl Clavenna is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Carl Clavenna's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Carl Clavenna reassigns Medicare benefits to Beaumont Medical Group- Specialty Services (Royal Oak, MI). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Carl Clavenna's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Carl Clavenna accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Meridian and Priority Health list Carl Clavenna as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Carl Clavenna was last updated on November 17, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.