CLAIRE MCGRODER M.D.
NPI 1396130886
Internal Medicine - Pulmonary Disease in New York, NY

Active since April 01, 2015PECOS EnrolledAccepts Medicare Assignment
100/100
CMS Quality Rating
161 FORT WASHINGTON AVE FL 3, NEW YORK, NY 10032(212) 305-8203(212) 305-8426 Get Directions Write a Review

NPPES record last updated: February 6, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Feb 6, 2024, Apr 27, 2021, Dec 22, 2015 (3 updates tracked since 2015).

About Claire Mcgroder M.d. NPPES

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

CLAIRE MCGRODER M.D. (NPI 1396130886) is an individual pulmonary disease provider in New York, New York, licensed in New York (292346) and active in the NPI registry since April 2015. She is enrolled in Medicare PECOS, is affiliated with New York-presbyterian Hospital, and is a graduate of Other (2015).

NPPES Registry Identity

NPI1396130886
Entity TypeIndividualFemale
Primary Taxonomy207RP1001X
Provider Legal NameCLAIRE MCGRODERCredential: M.D.
Location Address161 FORT WASHINGTON AVE FL 3New York, NY 10032-3729
Mailing Address630 W 168th St # 4New York, NY 10032-3725 · (212) 305-8203 · Fax (212) 305-8426
Fax(212) 305-8426
Sole ProprietorNo
Medical School CMSOtherGraduated 2015
Enumeration DateApril 1, 2015
Last NPPES UpdateFebruary 6, 20243 updates tracked since enumeration
NPPES CertifiedFebruary 6, 2024
NPI 1396130886 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

Primary SpecialtyInternal Medicine · Pulmonary DiseaseAllopathic & Osteopathic Physicians
Taxonomy Code207RP1001X
License Licensed in NY · 292346
Definition
An internist who treats diseases of the lungs and airways. The pulmonologist diagnoses and treats cancer, pneumonia, pleurisy, asthma, occupational and environmental diseases, bronchitis, sleep disorders, emphysema and other complex disorders of the lungs.
Also ListedInternal MedicineTaxonomy 207R00000X · License 292346 (NY)
Also ListedInternal Medicine · Critical Care MedicineTaxonomy 207RC0200X · License 292346 (NY)
161 FORT WASHINGTON AVE FL 3, New York, NY 10032

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

Claire Mcgroder M.d. 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 ID1355746504
PECOS Enrollment IDI20210825003828
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 12

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.

Test to examine how well the lungs exchange gases 94729
This is a test called a pulmonary function test, which helps understand the efficiency of your lungs. It measures how much air your lungs can hold, how quickly you can move air in and out of your lungs, and how well your lungs put oxygen into and remove carbon dioxide from your blood.
175 services171 patients
Test to measure expiratory airflow and volume 94010
This test, known as spirometry, assesses how well your lungs work. It measures how much air you can inhale, how much you can exhale and how quickly you can exhale. It's non-invasive and helps diagnose conditions like asthma or COPD.
172 services138 patients
Test to measure rate of airflow 94375
This test, known as spirometry, measures how much air you can breathe in and out, and how quickly you can do so. It helps assess your lung function and can be used to diagnose or monitor conditions like asthma or COPD.
170 services165 patients
Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more 99215
This service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.
141 services88 patients
New patient office or other outpatient visit with a high level of medical decision making, if using time, 60 minutes or more 99205
This is a first-time patient visit where a healthcare professional spends 60-74 minutes with you. It involves a comprehensive evaluation, including your medical history and current health condition. They'll also advise on preventive health measures and formulate a treatment plan if needed.
57 services57 patients
Critical care, first 30-74 minutes 99291
Critical care involves immediate and constant attention by a team of specially-trained health professionals. It's for patients with life-threatening conditions, requiring first 30-74 minutes of intense monitoring and treatment.
50 services36 patients

Hospital Affiliations CMS Care Compare 2

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

New York-Presbyterian Hospital

Acute Care Hospitals · New York, NY
5/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number330101
Location525 East 68th StreetNew York, NY 10065 · New York County
Emergency services Birthing friendly

Helen Hayes Hospital

Acute Care Hospitals · West Haverstraw, NY
OwnershipGovernment - State
CMS Certification Number330405
Location51 North Route 9WWest Haverstraw, NY 10993 · Rockland County

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 10032 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
$150.24 typical visit price
range $65.69 – $198.19
Typical copayment $37.56 (range $16.42 – $49.54)
Most-billed visit code 99204
Established Patient
$114.88 typical visit price
range $21.20 – $160.66
Typical copayment $28.72 (range $5.30 – $40.16)
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.

100/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored through an Alternative Payment Model
Quality86.8
Promoting Interoperability100
Improvement Activities40

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.

Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate E1390
DME-Oxygen and Supplies · category DC002N
3 suppliers15 claims15 services$81.05 avg. paid by Medicare
Portable gaseous oxygen system, rental; home compressor used to fill portable oxygen cylinders; includes portable containers, regulator, flowmeter, humidifier, cannula or mask, and tubing K0738
DME-Oxygen and Supplies · category DC000N
2 suppliers14 claims14 services$31.99 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 5

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

Nurse Practitioner (Family)
161 FORT WASHINGTON AVE FL 3
NEW YORK, NY 10032
Nurse Practitioner (Acute Care)
161 FORT WASHINGTON AVE FL 3
NEW YORK, NY 10032
Nurse Practitioner (Family)
161 FORT WASHINGTON AVE FL 3
NEW YORK, NY 10032
Internal Medicine (Pulmonary Disease)
161 FORT WASHINGTON AVE FL 3
NEW YORK, NY 10032
Nurse Practitioner (Adult Health)
161 FORT WASHINGTON AVE FL 3
NEW YORK, NY 10032

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 Claire Mcgroder's NPI number?

The NPI number for Claire Mcgroder is 1396130886. It was assigned to this individual provider in the NPPES registry on April 1, 2015.

Where is Claire Mcgroder located?

Claire Mcgroder practices at 161 Fort Washington Ave Fl 3, New York, NY 10032. The listed phone number is (212) 305-8203.

What is Claire Mcgroder's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Pulmonary Disease, with taxonomy code 207RP1001X.

Is Claire Mcgroder enrolled in Medicare?

Yes. Claire Mcgroder 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.

Is Claire Mcgroder affiliated with any hospitals?

According to CMS data, Claire Mcgroder is affiliated with New York-Presbyterian Hospital and Helen Hayes Hospital.

When was this NPI record last updated?

The NPPES record for Claire Mcgroder was last updated on February 6, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.