CRAIG J MCCLAIN MD
NPI 1225092349
Internal Medicine - Gastroenterology in Louisville, KY

Q: What is Craig Mcclain's NPI number?

The NPI number for Craig Mcclain is 1225092349. It was assigned to this individual provider in the NPPES registry on April 14, 2006.

Q: What is Craig Mcclain's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Gastroenterology, with taxonomy code 207RG0100X.

Q: When was this NPI record last updated?

The NPPES record for Craig Mcclain was last updated on February 14, 2017. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 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.

Active since April 14, 2006PECOS EnrolledAccepts Medicare Assignment

73.19/100

CMS Quality Rating

401 E CHESTNUT ST, SUITE 310, LOUISVILLE, KY 40202(502) 584-8563(502) 562-6196 Get Directions Write a Review

NPPES record last updated: February 14, 2017. Verified against the NPPES registry weekly; last sync: October 04, 2026.

On this page

About Craig J Mcclain Md NPPES

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

CRAIG J MCCLAIN MD (NPI 1225092349) is an individual gastroenterology provider in Louisville, Kentucky, licensed in Kentucky (22402) and active in the NPI registry since April 2006. He is enrolled in Medicare PECOS, is affiliated with Baptist Health Hardin, and is a graduate of University Of Tennessee, Hsc, College Of Medicine (1972).

NPPES Registry Identity

NPI1225092349

Entity TypeIndividualMale

Primary Taxonomy207RG0100X

Provider Legal NameCRAIG J MCCLAINCredential: MD

Location Address401 E CHESTNUT ST, SUITE 310Louisville, KY 40202-5700

Mailing AddressPo Box 909, Suite 220Louisville, KY 40201-0909 · (502) 588-0320 · Fax (502) 588-0326

Phone(502) 584-8563

Fax(502) 562-6196

Sole ProprietorNo

Medical School CMSUniversity Of Tennessee, Hsc, College Of MedicineGraduated 1972

Enumeration DateApril 14, 2006

Last NPPES UpdateFebruary 14, 2017

✔ NPI 1225092349 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyInternal Medicine · GastroenterologyAllopathic & Osteopathic Physicians

Taxonomy Code207RG0100X

License✔ Licensed in KY · 22402

Definition

An internist who specializes in diagnosis and treatment of diseases of the digestive organs including the stomach, bowels, liver and gallbladder. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using endoscopes to visualize internal organs.

Also ListedInternal MedicineTaxonomy 207R00000X · License 22402 (KY)

Also ListedInternal Medicine · HepatologyTaxonomy 207RI0008X · License 22402 (KY)

401 E CHESTNUT ST, Louisville, KY 40202

Open in Google Maps ↗

Other Identifiers 1

Medicaid64244025KY

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter from Home State Health, Ambetter Health 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

Craig J Mcclain 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 ID5395770929

PECOS Enrollment IDI20071008000445

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

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 moderate level of decision making, if using time, 30 minutes or more 99214

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

48 services38 patients

Hospital Affiliations CMS Care Compare 3

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Baptist Health Hardin

Acute Care Hospitals · Elizabethtown, KY

3/5 CMS rating

OwnershipGovernment - Local

CMS Certification Number180012

Location913 North Dixie AvenueElizabethtown, KY 42701 · Hardin County

Emergency services

Jewish Hospital & St Mary's Healthcare

Acute Care Hospitals · Louisville, KY

2/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number180040

Location200 Abraham Flexner WayLouisville, KY 40202 · Jefferson County

Emergency services

University Of Louisville Hospital

Acute Care Hospitals · Louisville, KY

1/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number180141

Location530 South Jackson StreetLouisville, KY 40202 · Jefferson County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 40202 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

$122.77 typical visit price

range $52.76 – $162.27

Typical copayment $30.69 (range $13.19 – $40.56)

Most-billed visit code 99204

Established Patient

$93.94 typical visit price

range $16.53 – $131.99

Typical copayment $23.48 (range $4.13 – $32.99)

Most-billed visit code 99214

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.

73.19/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Scored as part of a group practice

Quality

58.74

Promoting Interoperability

100

Improvement Activities

Cost

51.91

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.

DR. CHRISTOPHER R. SHAFER M.D.

Psychiatry & Neurology (Neurology)

401 E CHESTNUT ST, SUITE 510
LOUISVILLE, KY 40202

Jefferson County (502) 588-4800

KELLI M. BULLARD DUNN MD

Colon & Rectal Surgery

401 E CHESTNUT ST, SUITE 710
LOUISVILLE, KY 40202

Jefferson County (502) 583-8303

JASON WAYNE SMITH MD

Surgery (Surgical Critical Care)

401 E CHESTNUT ST, SUITE 710
LOUISVILLE, KY 40202

Jefferson County (502) 583-8303

SRI PRAKASH L MOKSHAGUNDAM MD

Internal Medicine (Endocrinology, Diabetes & Metabolism)

401 E CHESTNUT ST, STE #310
LOUISVILLE, KY 40202

Jefferson County (502) 588-4600

DR. VICTORIA SKELTON YUNKER MD.

Psychiatry & Neurology (Psychiatry)

401 E CHESTNUT ST, SUITE 610
LOUISVILLE, KY 40202

Jefferson County (502) 588-4450

THERESA BRADSHAW BS

Occupational Therapist (Neurorehabilitation)

401 E CHESTNUT ST, SUITE 510
LOUISVILLE, KY 40202

Jefferson County (502) 589-0802

UNIVERSITY OF LOUISVILLE RESEARCH FOUNDATION

Surgery (Trauma Surgery)

401 E CHESTNUT ST, SUITE 710
LOUISVILLE, KY 40202

Jefferson County (502) 583-8303

UNIVERSITY OF LOUISVILLE RESEARCH FOUNDATION

Psychiatry & Neurology (Neurology)

401 E CHESTNUT ST, SUITE 510
LOUISVILLE, KY 40202

Jefferson County (502) 589-0802

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 Craig Mcclain's NPI number?

The NPI number for Craig Mcclain is 1225092349. It was assigned to this individual provider in the NPPES registry on April 14, 2006.

Where is Craig Mcclain located?

Craig Mcclain practices at 401 E Chestnut St Suite 310, Louisville, KY 40202. The listed phone number is (502) 584-8563.

What is Craig Mcclain's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Gastroenterology, with taxonomy code 207RG0100X.

Is Craig Mcclain enrolled in Medicare?

Yes. Craig Mcclain 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 Craig Mcclain accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Home State Health, Ambetter of Tennessee and CareSource list Craig Mcclain 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.

Is Craig Mcclain affiliated with any hospitals?

According to CMS data, Craig Mcclain is affiliated with Baptist Health Hardin, Jewish Hospital & St Mary's Healthcare and University Of Louisville Hospital.

When was this NPI record last updated?

The NPPES record for Craig Mcclain was last updated on February 14, 2017. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 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.