THERESA MCCLAIN D.O.
NPI 1235573916
Obstetrics & Gynecology in Allentown, PA

Q: What is Theresa Mcclain's NPI number?

The NPI number for Theresa Mcclain is 1235573916. It was assigned to this individual provider in the NPPES registry on April 24, 2013.

Q: What is Theresa Mcclain's specialty?

The primary specialty registered for this NPI is Obstetrics & Gynecology with taxonomy code 207V00000X.

Q: When was this NPI record last updated?

The NPPES record for Theresa Mcclain was last updated on January 13, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 months 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 24, 2013PECOS EnrolledAccepts Medicare Assignment

71.53/100

CMS Quality Rating

1611 POND RD STE 300, ALLENTOWN, PA 18104(610) 398-7700(610) 398-3917 Get Directions Write a Review

NPPES record last updated: January 13, 2026. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jan 13, 2026, Aug 9, 2021, Jan 31, 2019 and 2 more (5 updates tracked since 2018).

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About Theresa Mcclain D.o. NPPES

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

THERESA MCCLAIN D.O. (NPI 1235573916) is an individual obstetrics & gynecology provider in Allentown, Pennsylvania, licensed in Pennsylvania (OS018924) and active in the NPI registry since April 2013. She is enrolled in Medicare PECOS, is affiliated with Penn State Health St. Joseph, and maintains 2 additional practice locations.

NPPES Registry Identity

NPI1235573916

Entity TypeIndividualFemale

Primary Taxonomy207V00000X

Provider Legal NameTHERESA MCCLAINCredential: D.O.

Location Address1611 POND RD STE 300Allentown, PA 18104

Mailing Address2494 Bernville Rd Ste 100Reading, PA 19605-9466 · (610) 378-2899 · Fax (610) 378-2980

Phone(610) 398-7700

Fax(610) 398-3917

Sole ProprietorNo

Medical School CMSOtherGraduated 2013

Enumeration DateApril 24, 2013

Last NPPES UpdateJanuary 13, 20265 updates tracked since enumeration

NPPES CertifiedJanuary 13, 2026

✔ NPI 1235573916 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyObstetrics & GynecologyAllopathic & Osteopathic Physicians

Taxonomy Code207V00000X

License✔ Licensed in PA · OS018924

Definition

An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women.

1611 POND RD STE 300, Allentown, PA 18104

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Secondary Practice Locations 2

Location 11330 Penn AveWyomissing, PA 19610 · Phone (610) 373-3738 · Fax (610) 373-4938

Location 2500 University DrHershey, PA 17033-2360 · Phone (800) 243-1455

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

Theresa Mcclain D.o. 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 ID8022302561

PECOS Enrollment IDI20171106000062

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.

Cervical or vaginal cancer screening; pelvic and clinical breast examination G0101

This procedure involves checking for health issues in the lower abdomen and chest area. It helps identify early signs of certain conditions, increasing the chance for successful treatment. It's a routine check-up that's important for maintaining good health.

33 services33 patients

Hospital Affiliations CMS Care Compare

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

Penn State Health St. Joseph

Acute Care Hospitals · Reading, PA

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number390096

Location2500 Bernville RoadReading, PA 19605 · Berks County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 18104 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

$126.34 typical visit price

range $54.64 – $166.87

Typical copayment $31.58 (range $13.66 – $41.71)

Most-billed visit code 99204

Established Patient

$68.36 typical visit price

range $17.33 – $135.84

Typical copayment $17.09 (range $4.33 – $33.96)

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.

71.53/100

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

Scored as part of a group practice

Quality

55.53

Promoting Interoperability

100

Improvement Activities

Cost

49.57

Other Providers at the Same Location NPPES 14

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

DR. ALEXIS JACQUELINE ACHEY LEWIS DO

Obstetrics & Gynecology