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JAMES W KLEIN MD
NPI 1104828482
Ophthalmology in St Clair Shores, MI

Active since June 01, 2005PECOS EnrolledAccepts Medicare Assignment
75.7/100
CMS Quality Rating
21711 GREATER MACK AVE, ST CLAIR SHORES, MI 48080(586) 774-0393 Get Directions Write a Review

NPPES record last updated: June 3, 2008. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About James W Klein Md NPPES

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

JAMES W KLEIN MD (NPI 1104828482) is an individual ophthalmology provider in St Clair Shores, Michigan, licensed in Michigan (4301039578) and active in the NPI registry since June 2005. He is enrolled in Medicare PECOS and is a graduate of Illinois Medical College (1971).

NPPES Registry Identity

NPI1104828482
Entity TypeIndividualMale
Primary Taxonomy207W00000X
Provider Legal NameJAMES W KLEINCredential: MD
Location Address21711 GREATER MACK AVESt Clair Shores, MI 48080-2418
Mailing Address21711 Greater Mack AveSt Clair Shores, MI 48080-2418 · (586) 774-0393
Phone(586) 774-0393
Sole ProprietorNo
Medical School CMSIllinois Medical CollegeGraduated 1971
Enumeration DateJune 1, 2005
Last NPPES UpdateJune 3, 2008
✔ NPI 1104828482 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOphthalmologyAllopathic & Osteopathic Physicians
Taxonomy Code207W00000X
License✔ Licensed in MI · 4301039578
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.
21711 GREATER MACK AVE, St Clair Shores, MI 48080
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Other Identifiers 3

Medicare UPINB45340MI
Medicare PIN0M01130MI
Other180041197MI · Medicare Railroad

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, Blue Care Network of Michigan, Blue Cross and Blue Shield of Louisiana 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 and accepts Medicare assignment

James W Klein Md 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 ID446253249
PECOS Enrollment IDI20100916000620
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 James Klein reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Richard C Mertz Jr MD PC
Same address
Ophthalmology
21711 GREATER MACK AVE
St Clair Shores, MI 48080
  • Reassigned Medicare billing, Michigan enrollment
  • 8 clinicians in this Medicare group
NPI 1467408914 (586) 774-0393

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

Areas of Expertise CMS Part B claims 15

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.

Injection, faricimab-svoa, 0.1 mg J2777
Faricimab-svoa is a medication given through an injection into the eye to treat certain eye conditions. The 0.1 mg dosage helps control disease progression, improving vision and eye health. The procedure is done by a healthcare professional.
2,521 services13 patients
Established patient problem focused exam of visual system 92012
This is a routine check-up for existing patients focusing on the visual system. It involves examining your eyes to detect any potential issues or changes in your vision. It's a crucial part of maintaining good eye health.
414 services281 patients
Established patient complete exam of visual system 92014
An established patient complete exam of the visual system involves a thorough check of your eyes and vision. It assesses eye health, checks for diseases, and measures your ability to see clearly at different distances. It's a routine, non-invasive procedure.
355 services354 patients
Photography of the retina 92250
Photography of the retina, also known as retinal imaging, is a non-invasive procedure that captures images of the back of your eye. This helps doctors identify and monitor conditions like glaucoma, macular degeneration, or diabetic retinopathy. It's painless and quick, often part of a routine eye exam.
334 services300 patients
Imaging of retina 92134
Imaging of the retina is a non-invasive procedure that captures detailed images of your eye's interior. This helps detect conditions like macular degeneration or retinal detachment. It's painless and takes only a few minutes.
317 services101 patients
Injection of drug into eye 67028
An injection into the eye is a procedure where a medication is delivered directly into your eye to treat various conditions. A local anesthetic is applied to numb the eye, ensuring minimal discomfort. The drug helps manage diseases like macular degeneration or diabetic retinopathy.
282 services58 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 48080 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.

75.7/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality99.55
Improvement Activities40
Cost19.61

Reported Quality Measures

Age-Related Macular Degeneration (AMD): Counseling on Antioxidant Supplement
Percentage of patients aged 50 years and older with a diagnosis of age-related macular degeneration (AMD) or their caregiver(s) who were counseled within 12 months on the benefits and/or risks of the Age-Related Eye Disease Study (AREDS) formulation for…
92%152 patients4/55-star benchmark: 100%
Age-Related Macular Degeneration (AMD): Dilated Macular Examination
Percentage of patients aged 50 years and older with a diagnosis of age-related macular degeneration (AMD) who had a dilated macular examination performed which included documentation of the presence or absence of macular thickening or geographic atrophy or…
100%152 patients5/55-star benchmark: 100%
Cataracts: 20/40 or Better Visual Acuity within 90 Days Following Cataract Surgery
Percentage of patients aged 18 years and older with a diagnosis of uncomplicated cataract who had cataract surgery and no significant ocular conditions impacting the visual outcome of surgery and had best-corrected visual acuity of 20/40 or better (distance…
96%122 patients
Closing the Referral Loop: Receipt of Specialist Report
Percentage of patients with referrals, regardless of age, for which the referring provider receives a report from the provider to whom the patient was referred
61%36 patients3/55-star benchmark: 95%
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
100%194 patients5/55-star benchmark: 100%
Diabetic Retinopathy: Communication with the Physician Managing Ongoing Diabetes Care
Percentage of patients aged 18 years and older with a diagnosis of diabetic retinopathy who had a dilated macular or fundus exam performed with documented communication to the physician who manages the ongoing care of the patient with diabetes mellitus…
100%42 patients5/55-star benchmark: 100%
Diabetic Retinopathy: Documentation of Presence or Absence of Macular Edema and Level of Severity of Retinopathy
Percentage of patients aged 18 years and older with a diagnosis of diabetic retinopathy who had a dilated macular or fundus exam performed which included documentation of the level of severity of retinopathy and the presence or absence of macular edema during…
100%43 patients5/55-star benchmark: 100%
Documentation of Current Medications in the Medical Record
Percentage of visits for patients aged 18 years and older for which the eligible professional or eligible clinician attests to documenting a list of current medications using all immediate resources available on the date of the encounter.
100%4,917 patients5/55-star benchmark: 100%
e-Prescribing
At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology.
96%1,205 patients4/55-star benchmark: 100%
Falls: Screening for Future Fall Risk
Percentage of patients 65 years of age and older who were screened for future fall risk during the measurement period
95%1,706 patients4/55-star benchmark: 99%
Health Information Exchange
The MIPS eligible clinician that transitions or refers their patient to another setting of care or health care clinician (1) uses CEHRT to create a summary of care record; and (2) electronically transmits such summary to a receiving health care clinician for…
35%34 patients2/55-star benchmark: 98%
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.
96%2,124 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.
98%2,628 patients4/55-star benchmark: 100%
Pneumococcal Vaccination Status for Older Adults
Percentage of patients 65 years of age and older who have ever received a pneumococcal vaccine
87%158 patients4/55-star benchmark: 90%
Preventive Care and Screening: Influenza Immunization
Percentage of patients aged 6 months and older seen for a visit between October 1 and March 31 who received an influenza immunization OR who reported previous receipt of an influenza immunization
52%75 patients3/55-star benchmark: 88%
Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention
Percentage of patients aged 18 years and older who were screened for tobacco use one or more times within 24 months AND who received tobacco cessation intervention if identified as a tobacco user
Patients screenedForUse: 97% · 1,160 patients
Patients tobacco: 93% · 1,160 patients
27%67 patients2/55-star benchmark: 98%
Primary Open-Angle Glaucoma (POAG): Optic Nerve Evaluation
Percentage of patients aged 18 years and older with a diagnosis of primary open-angle glaucoma (POAG) who have an optic nerve head evaluation during one or more office visits within 12 months
100%413 patients5/55-star benchmark: 100%
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…
99%2,628 patients4/55-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…
95%2,628 patients5/55-star benchmark: 79%
Use of High-Risk Medications in the Elderly
Percentage of patients 65 years of age and older who were ordered high-risk medications. Two rates are submitted. 1) Percentage of patients who were ordered at least one high-risk medication.
Lower rates are better for this measure.
Patients 2+: 0% · 1,695 patients
0%1,695 patients5/55-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.

Referred Medical Equipment & Supplies CMS DME claims 2

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Frames, purchases V2020
Other-Vision, Hearing, and Speech Services · category OC000N
1 supplier19 claims19 services$58.51 avg. paid by Medicare
Sphere, trifocal, plano to plus or minus 4.00d, per lens V2300
Other-Vision, Hearing, and Speech Services · category OC000N
1 supplier12 claims24 services$51.71 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 6

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

RICHARD C MERTZ JR MD PC
Clinic/Center (Ambulatory Surgical)
21711 GREATER MACK AVE
SAINT CLAIR SHORES, MI 48080
Macomb County (586) 774-0393
MARIANN M CHANNELL MD
Ophthalmology
21711 GREATER MACK AVE
ST CLAIR SHORES, MI 48080
Macomb County (586) 774-0393
ST CLAIR SHORES MI OPHTHALMOLOGY ASC LLC
Clinic/Center (Ambulatory Surgical)
21711 GREATER MACK AVE
SAINT CLAIR SHORES, MI 48080
Macomb County (586) 774-0393
RICHARD C MERTZ JR MD PC
Ophthalmology
21711 GREATER MACK AVE
ST CLAIR SHORES, MI 48080
Macomb County (586) 774-0393
SHOREPOINTE OPTICAL INC
Eyewear Supplier
21711 GREATER MACK AVE
SAINT CLAIR SHORES, MI 48080
Macomb County (586) 774-9320
MARK E BERNTHAL OD
Optometrist
21711 GREATER MACK AVE
ST CLAIR SHORES, MI 48080
Macomb County (586) 774-0393

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 James Klein's NPI number?

The NPI number for James Klein is 1104828482. It was assigned to this individual provider in the NPPES registry on June 1, 2005.

Where is James Klein located?

James Klein practices at 21711 Greater Mack Ave, St Clair Shores, MI 48080. The listed phone number is (586) 774-0393.

What is James Klein's specialty?

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

Is James Klein enrolled in Medicare?

Yes. James Klein 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.

Which organization bills Medicare for James Klein's services?

According to the CMS Revalidation Reassignment List (October 2026 release), James Klein reassigns Medicare benefits to Richard C Mertz Jr MD PC (St Clair Shores, 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 James Klein's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does James Klein accept?

Health plans from Anthem Blue Cross and Blue Shield, Blue Care Network of Michigan, Blue Cross Blue Shield of Michigan Mutual Insurance Company, Blue Cross Blue Shield of Wyoming and Blue Cross and Blue Shield of Louisiana and 13 other insurers list James Klein 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 James Klein was last updated on June 3, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 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.