DR. ROBERT MCCLURE III M.D.
NPI 1295818672
Dermatology - Procedural Dermatology in Lilburn, GA

Quality Rating: 92.93 out of 100 score

NPI Status: Active since October 23, 2006

Contact Information

5024 LAWRENCEVILLE HWY NW
LILBURN, GA
ZIP 30047
Phone: (770) 921-4740
Fax: (770) 921-1993

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Table of Contents

NPI Profile Information
Primary Taxonomy
Insurance Plans Accepted
Medicare Participation & PECOS Status
Areas of Expertise
Physician Visit Costs
Overall Quality Performance
Quality Reporting
NPI Validation
Frequently Asked Questions

Individual
Male
Dermatology
Procedural Dermatology
PECOS Enrolled
Medicare Quality Reporting

About ROBERT MCCLURE

This page provides the complete NPI Profile along with additional information for Robert Mcclure, a provider established in Lilburn, Georgia with a medical specialization in Dermatology, focusing in procedural dermatology . The healthcare provider is registered in the NPI registry with number 1295818672 assigned on October 2006. The practitioner's primary taxonomy code is 207NS0135X with license number 017631 (GA). The provider is registered as an individual and his NPI record was last updated 19 years ago.

NPI: 1295818672
Provider Name: DR. ROBERT MCCLURE III M.D.
Gender: Male
Entity Type: Individual
Location Address: 5024 LAWRENCEVILLE HWY NW LILBURN, GA 30047
Location Phone: (770) 921-4740
Location Fax: (770) 921-1993
Mailing Address: 5024 LAWRENCEVILLE HWY NW LILBURN, GA 30047
Mailing Phone: (770) 921-4740
Mailing Fax: (770) 921-1993
Is Sole Proprietor?: Yes
Enumeration Date: 10-23-2006
Last Update Date: 07-08-2007
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Location Map

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification: Dermatology Procedural Dermatology
Taxonomy Code: 207NS0135X
Type: Allopathic & Osteopathic Physicians
License No.: 017631
License State: GA
Taxonomy Description: Procedural Dermatology, a subspecialty of Dermatology, encompassing a wide variety of surgical procedures and methods to remove or modify skin tissue for health or cosmetic benefit. These methods include scalpel surgery, laser surgery, chemical surgery, cryosurgery (liquid nitrogen), electrosurgery, aspiration surgery, liposuction, injection of filler substances, and Mohs micrographic controlled surgery (a special technique for the removal of growths, especially skin cancers).

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

Medicare

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Medicaid

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Additional Identifiers

The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier	Type / Code	Identifier State	Identifier Issuer
D68963	MEDICARE UPIN (02)	GA

Medicare Participation & PECOS Enrollment Status

Robert Mcclure is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.

What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.

Is the provider registered in PECOS? Yes
Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes
Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes
Eligible to Order or Refer a Home Health Agency (HHA): Yes
Eligible to Order or Refer Power Mobility Devices: Yes

Areas of Expertise

The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.

Biopsy of ear
Biopsy of related skin growth, each additional growth
Biopsy of related skin growth, first growth
Complicated repair of wound of forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, or feet, 2.6-7.5 cm
Complicated repair of wound of scalp, arms, or legs, 2.6-7.5 cm
Complicated repair of wound of scalp, arms, or legs, each additional 5.0 cm or less
Complicated repair of wound of trunk, 2.6-7.5 cm
Destruction of cancer skin growth of face, ears, eyelids, nose, lips, or mouth, 0.6-1.0 cm
Destruction of cancer skin growth of face, ears, eyelids, nose, lips, or mouth, 1.1-2.0 cm
Destruction of cancer skin growth of scalp, neck, hands, feet, or genitals, 0.6-1.0 cm
Destruction of cancer skin growth of scalp, neck, hands, feet, or genitals, 1.1-2.0 cm
Destruction of cancer skin growth of trunk, arms, or legs, 0.6-1.0 cm
Destruction of cancer skin growth of trunk, arms, or legs, 1.1-2.0 cm
Destruction of precancer skin growth, 1 growth
Destruction of precancer skin growth, 2-14 growths
Destruction of skin growth, 1-14 growths
Established patient office or other outpatient visit, 10-19 minutes
Established patient office or other outpatient visit, 20-29 minutes
Established patient office or other outpatient visit, 30-39 minutes
New patient office or other outpatient visit, 30-44 minutes
New patient office or other outpatient visit, 45-59 minutes
Removal of cancer skin growth of body, arms, or legs, 1.1-2.0 cm
Shaving of skin growth of body, arms, or legs, 0.5 cm or less
Shaving of skin growth of body, arms, or legs, 0.6-1.0 cm
Shaving of skin growth of body, arms, or legs, 1.1-2.0 cm
Shaving of skin growth of face, ears, eyelids, nose, lips, or mouth, 0.5 cm or less
Shaving of skin growth of face, ears, eyelids, nose, lips, or mouth, 0.6-1.0 cm
Shaving of skin growth of face, ears, eyelids, nose, lips, or mouth, 1.1-2.0 cm
Shaving of skin growth of scalp, neck, hands, feet, or genitals, 0.5 cm or less
Shaving of skin growth of scalp, neck, hands, feet, or genitals, 0.6-1.0 cm
Shaving of skin growth of scalp, neck, hands, feet, or genitals, 1.1-2.0 cm

Physician Visit Costs

The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.

For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.

The prices below reflect the costs for new and established patients in the 30047 ZIP code area.

New Patients Visit Costs *

The most utilized procedure code for new patients office visits is 99203

Average New Patient Price $88.06
Minimum New Patient Price $56.84
Maximum New Patient Price $172.43

Average New Patient Copayment $22.01
Minimum New Patient Copayment $14.21
Maximum New Patient Copayment $43.1

Established Patients Visit Costs *

The most utilized procedure code for established patients office visits is 99213

Average Established Patient Price $70.85
Minimum Established Patient Price $18.22
Maximum Established Patient Price $140.4

Average Established Patient Copayment $17.71
Minimum Established Patient Copayment $4.55
Maximum Established Patient Copayment $35.1

* The physician office visit costs information is generated by statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.

Overall MIPS Quality Performance

The provider participated in CMS Quality Payment Program under the Merit-based Incentive Payment System (MIPS) and has an overall final score of 92.93, based on four performance areas: quality, improvement activities, promoting interoperability, and cost. The purpose of this information is to help people with Medicare make informed decisions and incentivize doctors and clinicians to maximize performance.

The Merit-based Incentive Payment System (MIPS) is a way providers could use to participate in CMS Quality Payment Program (QPP). The MIPS program affects clinician reimbursement for Part B covered professional services and also rewards them for improving the quality of patient care and outcomes.

Final Score: 92.93 out of 100

The MIPS program evaluates providers across multiple categories with a specific weight for each category resulting a in a MIPS final score that ranges from 0 to 100 points. The MIPS Final Score determines whether providers receive a negative, neutral or positive MIPS payment adjustment.
Quality Score: 80.38

The Quality category assesses providers performance on clinical practices and patient outcomes under the traditional MIPS program. The quality measures help identify the quality of healthcare processes, outcomes, and patient experiences. The Quality measure category compromises 40% providers final MPIS scores.

There are six collection types for MIPS quality measures: Electronic Clinical Quality Measures (eCQMs), MIPS Clinical Quality Measures (CQMs), Qualified Clinical Data Registry (QCDR) Measures, Medicare Part B claims measures, CMS Web Interface measures and The Consumer Assessment of Healthcare Providers and Systems (CAHPS) for MIPS Survey.
Promoting Interoperability Score: 100

The Interoperability category measures the providers ability to use technology to exchange and make use of healthcare information in a way that is less burdensome and improves outcomes. The Interoperability measure category compromises 25% providers final MPIS scores.

The MIPS Interoperability measure focuses on the use of certified electronic health record technology (CEHRT) to improve patient access health information, the exchange of information between clinicians and pharmacies and the systematic collection, analysis, and interpretation of healthcare data.
Improvement Activities Score: 40

The Improvement Activities performance category evaluates the providers participation in clinical activities that support the improvement of clinical practice, care delivery, and outcomes. Providers have the option to choose 2 to 4 activities from an inventory of over 100 improvement activities. Providers typically choose the activities that best fit their needs. The improvement activities measure category compromises 15% providers final MPIS scores.

The Improvement measures aim to better patient engagement, patient safety and other areas of patient care. The Improvement Activities category compromises 15% of providers final MPIS scores.
Cost Score: N/A

The Cost performance category asses the amount and types of services provided and how clinicians coordinate care and seek improvement of health outcomes by ensuring patients receive the appropriate services.

Although providers don't determine the price of healthcare services they are important in delivering high-quality care at a reasonable cost. The Cost measures category compromises 20% of providers final MPIS scores.
Cost Score: N/A

The Cost performance category asses the amount and types of services provided and how clinicians coordinate care and seek improvement of health outcomes by ensuring patients receive the appropriate services.

Although providers don't determine the price of healthcare services they are important in delivering high-quality care at a reasonable cost. The Cost measures category compromises 20% of providers final MPIS scores.

Quality Reporting

The provider participated in CMS Quality Payment Program. The Quality Payment Program aims to improve population health, reduce costs and improve the care received by Medicare beneficiaries. The following quality measures meet Medicare's statistical reporting standards. Not all providers report the same information, because not all providers give the same services to patients. The quality information is just a snapshot of some the care providers give to their patients. Reporting more or less information is not a reflection of quality.

Quality Measure	Performance	Number of Patients
Care Plan	79%	1519
Percentage of patients aged 65 years and older who have an advance care plan or surrogate decision maker documented in the medical record that an advance care plan was discussed but the patient did not wish or was not able to name a surrogate decision maker or provide an advance care plan
Documentation of Current Medications in the Medical Record	27%	4315
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. This list must include ALL known prescriptions, over-the-counters, herbals, and vitamin/mineral/dietary (nutritional) supplements AND must contain the medications' name, dosage, frequency and route of administration
e-Prescribing	95%	614
At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology.
Implementation of improvements that contribute to more timely communication of test results	Yes	N/A
Timely communication of test results defined as timely identification of abnormal test results with timely follow-up.
Improved Practices that Disseminate Appropriate Self-Management Materials	Yes	N/A
Provide self-management materials at an appropriate literacy level and in an appropriate language.
Patient-Specific Education	97%	963
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.
Pneumococcal Vaccination Status for Older Adults	58%	1519
Percentage of patients 65 years of age and older who have ever received a pneumococcal vaccine
Provide 24/7 Access to MIPS Eligible Clinicians or Groups Who Have Real-Time Access to Patient's Medical Record	Yes	N/A
• Provide 24/7 access to MIPS eligible clinicians, groups, or care teams for advice about urgent and emergent care (e.g., MIPS eligible clinician and care team access to medical record, cross-coverage with access to medical record, or protocol-driven nurse line with access to medical record) that could include one or more of the following: • Expanded hours in evenings and weekends with access to the patient medical record (e.g., coordinate with small practices to provide alternate hour office visits and urgent care); • Use of alternatives to increase access to care team by MIPS eligible clinicians and groups, such as e-visits, phone visits, group visits, home visits and alternate locations (e.g., senior centers and assisted living centers); and/or Provision of same-day or next-day access to a consistent MIPS eligible clinician, group or care team when needed for urgent care or transition management.
Provide Patient Access	96%	963
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 certain information.
Security Risk Analysis	Yes	N/A
Conduct or review a security risk analysis in accordance with the requirements in 45 CFR 164.308(a)(1), including addressing the security (to include encryption) of ePHI data created or maintained by certified EHR technology in accordance with requirements in 45 CFR164.312(a)(2)(iv) and 45 CFR 164.306(d)(3), and implement security updates as necessary and correct identified security deficiencies as part of the MIPS eligible clinician's risk management process.
Specialized Registry Reporting	Yes	N/A
The MIPS eligible clinician is in active engagement to submit data to specialized registry. To earn a 5 % bonus in the promoting interoperability performance category score for submitting to one or more public health or clinical data registries also attest to PI_TRANS_PHCDRR_3_MULTI.

NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1295818672, we treat the final digit (2) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 68. The final step is to find the difference between that total and the next multiple of ten (70 - 68 = 2).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1

Doubled → 2

Pos 2

Unchanged

Pos 3

Doubled → 18 → 1 + 8

Pos 4

Unchanged

Pos 5

Doubled → 16 → 1 + 6

Pos 6

Unchanged

Pos 7

Doubled → 16 → 1 + 6

Pos 8

Unchanged

Pos 9

Doubled → 14 → 1 + 4

Check

Target digit

Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 9 → 18 → 9 8 → 16 → 7 8 → 16 → 7 7 → 14 → 5

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 2 + 1 + 8 + 5 + 1 + 6 + 1 + 1 + 6 + 6 + 1 + 4 + 24 = 68

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 68 is 70. The difference is the calculated check digit.

70 - 68 = 2

This NPI is valid

The calculated check digit is 2, which matches the last digit of 1295818672.

About ROBERT MCCLURE

Location Map

Specialty - Primary Taxonomy

Dermatology Procedural Dermatology

Insurance Plans Accepted

Medicare

Medicaid

Additional Identifiers

Medicare Participation & PECOS Enrollment Status

Is the provider registered in PECOS? Yes

Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes

Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes

Eligible to Order or Refer a Home Health Agency (HHA): Yes

Eligible to Order or Refer Power Mobility Devices: Yes

Areas of Expertise

Biopsy of ear

Biopsy of related skin growth, each additional growth

Biopsy of related skin growth, first growth

Complicated repair of wound of forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, or feet, 2.6-7.5 cm

Complicated repair of wound of scalp, arms, or legs, 2.6-7.5 cm

Complicated repair of wound of scalp, arms, or legs, each additional 5.0 cm or less

Complicated repair of wound of trunk, 2.6-7.5 cm

Destruction of cancer skin growth of face, ears, eyelids, nose, lips, or mouth, 0.6-1.0 cm

Destruction of cancer skin growth of face, ears, eyelids, nose, lips, or mouth, 1.1-2.0 cm

Destruction of cancer skin growth of scalp, neck, hands, feet, or genitals, 0.6-1.0 cm

Destruction of cancer skin growth of scalp, neck, hands, feet, or genitals, 1.1-2.0 cm

Destruction of cancer skin growth of trunk, arms, or legs, 0.6-1.0 cm

Destruction of cancer skin growth of trunk, arms, or legs, 1.1-2.0 cm

Destruction of precancer skin growth, 1 growth

Destruction of precancer skin growth, 2-14 growths

Destruction of skin growth, 1-14 growths

Established patient office or other outpatient visit, 10-19 minutes

Established patient office or other outpatient visit, 20-29 minutes

Established patient office or other outpatient visit, 30-39 minutes

New patient office or other outpatient visit, 30-44 minutes

New patient office or other outpatient visit, 45-59 minutes

Removal of cancer skin growth of body, arms, or legs, 1.1-2.0 cm

Shaving of skin growth of body, arms, or legs, 0.5 cm or less

Shaving of skin growth of body, arms, or legs, 0.6-1.0 cm

Shaving of skin growth of body, arms, or legs, 1.1-2.0 cm

Shaving of skin growth of face, ears, eyelids, nose, lips, or mouth, 0.5 cm or less

Shaving of skin growth of face, ears, eyelids, nose, lips, or mouth, 0.6-1.0 cm

Shaving of skin growth of face, ears, eyelids, nose, lips, or mouth, 1.1-2.0 cm

Shaving of skin growth of scalp, neck, hands, feet, or genitals, 0.5 cm or less

Shaving of skin growth of scalp, neck, hands, feet, or genitals, 0.6-1.0 cm

Shaving of skin growth of scalp, neck, hands, feet, or genitals, 1.1-2.0 cm

Physician Visit Costs

New Patients Visit Costs *

Established Patients Visit Costs *

Overall MIPS Quality Performance

Final Score: 92.93 out of 100

Quality Score: 80.38

Promoting Interoperability Score: 100

Improvement Activities Score: 40

Cost Score: N/A

Cost Score: N/A

Quality Reporting

Reviews for DR. ROBERT MCCLURE III M.D.

NPI NPI Number Validation

How NPI Validation Works

Digit-by-digit view

Step 1: Double every other digit from the right

Step 2: Add all digits plus the NPI constant

Step 3: Find the amount needed to reach the next multiple of 10

Frequently Asked Questions

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