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CLARENCE L NICODEMUS PHD DO
NPI 1063690535
Neuromusculoskeletal Medicine & OMM in East Lansing, MI

Active since February 06, 2008PECOS EnrolledAccepts Medicare Assignment
4660 S HAGADORN RD, SUITE 500, EAST LANSING, MI 48823(517) 432-6144(517) 432-6150 Get Directions Write a Review

NPPES record last updated: June 26, 2023. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jun 7, 2021, Sep 15, 2016 (2 updates tracked since 2016).

About Clarence L Nicodemus Phd Do NPPES

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

CLARENCE L NICODEMUS PHD DO (NPI 1063690535) is an individual neuromusculoskeletal medicine & omm provider in East Lansing, Michigan, licensed in Michigan (5101016107) and active in the NPI registry since February 2008. He is enrolled in Medicare PECOS and is a graduate of Michigan State University College Of Osteopathic Medicine (2000).

NPPES Registry Identity

NPI1063690535
Entity TypeIndividualMale
Primary Taxonomy204D00000X
Provider Legal NameCLARENCE L NICODEMUSCredential: PHD DO
Location Address4660 S HAGADORN RD, SUITE 500East Lansing, MI 48823-5376
Mailing Address804 Service Rd Ste A109bEast Lansing, MI 48824-7015 · (517) 432-6144 · Fax (517) 432-6150
Phone(517) 432-6144
Fax(517) 432-6150
Sole ProprietorNo
Medical School CMSMichigan State University College Of Osteopathic MedicineGraduated 2000
Enumeration DateFebruary 6, 2008
Last NPPES UpdateJune 26, 20232 updates tracked since enumeration
NPPES CertifiedJune 26, 2023
✔ NPI 1063690535 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNeuromusculoskeletal Medicine & OMMAllopathic & Osteopathic Physicians
Taxonomy Code204D00000X
License✔ Licensed in MI · 5101016107
Definition
The Neuromusculoskeletal Medicine and Osteopathic Manipulative Medicine physician directs special attention to the neuromusculoskeletal system and its interaction with other body systems. Neuromusculoskeletal Medicine and Osteopathic Manipulative Medicine encompasses increased knowledge and understanding of osteopathic principles and practice and heightened technical skills of osteopathic manipulative medicine, and integrates each of these into the management of pediatric, adolescent, adult, and geriatric patients.
4660 S HAGADORN RD, East Lansing, MI 48823
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Other Identifiers 1

Medicaid1063690535MI

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Care Network of Michigan, Blue Cross Blue Shield of Michigan Mutual Insurance Company, McLaren Health Plan Community and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Clarence L Nicodemus Phd Do is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID9436217270
PECOS Enrollment IDI20160923000188
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.

Areas of Expertise CMS Part B claims 4

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
143 services37 patients
Osteopathic manipulative treatment, 3-4 body regions 98926
Osteopathic Manipulative Treatment (OMT) is a hands-on method where a doctor uses specific techniques to diagnose, treat, and prevent illness or injury. For 3-4 body regions, the doctor focuses on areas like your head, neck, back, or limbs to improve function and promote healing.
73 services20 patients
Osteopathic manipulative treatment, 7-8 body regions 98928
Osteopathic Manipulative Treatment (OMT) is a hands-on method where physicians use precise movements to diagnose, treat, and prevent illness or injury. In a 7-8 body regions OMT, the doctor focuses on multiple areas, such as the head, neck, back, or limbs, to enhance your body's natural healing process.
45 services13 patients
New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204
This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.
20 services20 patients

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.

Reported Quality Measures

Colorectal Cancer Screening
Percentage of adults 50-75 years of age who had appropriate screening for colorectal cancer
13%181 patients1/55-star benchmark: 85%
Medication Reconciliation
The MIPS eligible clinician performs medication reconciliation for at least one transition of care in which the patient is transitioned into the care of the MIPS eligible clinician.
98%193 patients4/55-star benchmark: 100%
Patient-Specific Education
The MIPS eligible clinician must use clinically relevant information from CEHRT to identify patient-specific educational resources and provide access to those materials to at least one unique patient seen by the MIPS eligible clinician.
9%286 patients1/55-star benchmark: 97%
Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan
Percentage of patients aged 18 years and older with a BMI documented during the current encounter or during the previous twelve months AND with a BMI outside of normal parameters, a follow-up plan is documented during the encounter or during the previous…
24%285 patients2/55-star benchmark: 97%
Provide Patient Access
At least one patient seen by the MIPS eligible clinician during the performance period is provided timely access to view online, download, and transmit to a third party their health information subject to the MIPS eligible clinician's discretion to withhold…
100%286 patients5/55-star benchmark: 100%
Secure Messaging
For at least one unique patient seen by the MIPS eligible clinician during the performance period, a secure message was sent using the electronic messaging function of CEHRT to the patient (or the patient-authorized representative), or in response to a secure…
20%286 patients1/55-star benchmark: 89%
View, Download, or Transmit (VDT)
At least one patient seen by the MIPS eligible clinician during the performance period (or patient-authorized representative) views, downloads or transmits their health information to a third party during the performance period.
45%286 patients
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 20

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

MS. CATHERINE B DONAHUE D.O.
Neuromusculoskeletal Medicine & OMM
4660 S HAGADORN RD, #500
EAST LANSING, MI 48823
Ingham County (517) 432-6144
DR. JENNIFER LEE GILMORE D.O
Neuromusculoskeletal Medicine & OMM
4660 S HAGADORN RD, SUITE 500
EAST LANSING, MI 48823
Ingham County (517) 432-6144
ASHLEY DAY PA
Physician Assistant
4660 S HAGADORN RD, #600
EAST LANSING, MI 48823
Ingham County (517) 267-2460
INTERNATIONAL REHABILITATIVE SCIENCES INC.
Durable Medical Equipment & Medical Supplies
4660 S HAGADORN RD, STE 170
EAST LANSING, MI 48823
Ingham County (855) 503-4030
JEFFREY R MORIN DPM
Podiatrist (Foot & Ankle Surgery)
4660 S HAGADORN RD, STE 500
EAST LANSING, MI 48823
Ingham County (517) 884-4554
MRS. JAMIE FITZGERALD PNP
Nurse Practitioner (Pediatrics)
4660 S HAGADORN RD, 405
EAST LANSING, MI 48823
Ingham County (517) 884-8600
JUSTINE ANH QUY TRAN-SERRANO DO
Neuromusculoskeletal Medicine & OMM
4660 S HAGADORN RD
EAST LANSING, MI 48823
Ingham County (517) 432-6144
MRS. ANDREA LEE GANSS MS, AT, ATC
Specialist/Technologist (Athletic Trainer)
4660 S HAGADORN RD, 420
EAST LANSING, MI 48823
Ingham County (517) 884-6100

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 Clarence Nicodemus's NPI number?

The NPI number for Clarence Nicodemus is 1063690535. It was assigned to this individual provider in the NPPES registry on February 6, 2008.

Where is Clarence Nicodemus located?

Clarence Nicodemus practices at 4660 S Hagadorn Rd Suite 500, East Lansing, MI 48823. The listed phone number is (517) 432-6144.

What is Clarence Nicodemus's specialty?

The primary specialty registered for this NPI is Neuromusculoskeletal Medicine & OMM with taxonomy code 204D00000X.

Is Clarence Nicodemus enrolled in Medicare?

Yes. Clarence Nicodemus is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Clarence Nicodemus accept?

Health plans from Blue Care Network of Michigan, Blue Cross Blue Shield of Michigan Mutual Insurance Company, McLaren Health Plan Community and Priority Health list Clarence Nicodemus 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 Clarence Nicodemus was last updated on June 26, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.