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DR. NICHOLAS LEONE M.D.
NPI 1487735858
Ophthalmology in Clinton Township, MI

Active since October 18, 2006PECOS EnrolledAccepts Medicare Assignment
39400 GARFIELD RD, SUITE 103, CLINTON TOWNSHIP, MI 48038(586) 286-6550(586) 286-1843 Get Directions Write a Review

NPPES record last updated: July 8, 2007. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Dr. Nicholas Leone M.d. NPPES

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

DR. NICHOLAS LEONE M.D. (NPI 1487735858) is an individual ophthalmology provider in Clinton Township, Michigan, licensed in Michigan (4301057966) and active in the NPI registry since October 2006. He is enrolled in Medicare PECOS, is affiliated with Mckenzie Health System, and is a graduate of Wayne State University School Of Medicine (1991).

NPPES Registry Identity

NPI1487735858
Entity TypeIndividualMale
Primary Taxonomy207W00000X
Provider Legal NameDR. NICHOLAS LEONECredential: M.D.
Location Address39400 GARFIELD RD, SUITE 103Clinton Township, MI 48038-4096
Mailing Address39400 Garfield Rd, Suite 103Clinton Township, MI 48038-4096 · (586) 286-6550 · Fax (586) 286-1843
Phone(586) 286-6550
Fax(586) 286-1843
Sole ProprietorYes
Medical School CMSWayne State University School Of MedicineGraduated 1991
Enumeration DateOctober 18, 2006
Last NPPES UpdateJuly 8, 2007
✔ NPI 1487735858 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOphthalmologyAllopathic & Osteopathic Physicians
Taxonomy Code207W00000X
License✔ Licensed in MI · 4301057966
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.
39400 GARFIELD RD, Clinton Township, MI 48038
Open in Google Maps ↗

Other Identifiers 4

OtherOEO1563MI · Blue Cross Group Id
Medicare ID-Type UnspecifiedON93740
Medicare UPING13997
Other1805018242MI · Bcbs Pin

Accepted Insurance

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

Dr. Nicholas Leone 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 ID7810967742
PECOS Enrollment IDI20040728001429
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 9

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 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.
528 services450 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.
114 services88 patients
New patient complete exam of visual system 92004
A new patient complete exam of the visual system is a thorough evaluation of your eyes and vision. It checks for any potential issues and assesses overall eye health. It includes tests for visual acuity, eye movement, and light response.
111 services111 patients
Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
104 services89 patients
Exam of visual field with extended testing 92083
An extended visual field exam is a detailed test to evaluate your peripheral (side) vision. It helps to detect any potential blind spots which may not be noticeable in daily life. These could be caused by eye diseases like glaucoma, or neurological conditions.
77 services76 patients
Imaging of optic nerve 92133
Imaging of the optic nerve is a non-invasive procedure that captures detailed pictures of your optic nerve. It helps doctors assess eye health, particularly for conditions like glaucoma. It's painless, quick, and uses safe technology like MRI or OCT (Optical Coherence Tomography).
61 services60 patients

Hospital Affiliations CMS Care Compare

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

Mckenzie Health System

Critical Access Hospitals · Sandusky, MI
OwnershipVoluntary non-profit - Private
CMS Certification Number231314
Location120 N Delaware StreetSandusky, MI 48471 · Sanilac County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 48038 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.

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…
4%77 patients1/55-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…
92%77 patients4/55-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…
60%52 patients
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
95%201 patients4/55-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.
77%3,361 patients2/55-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.
70%149 patients3/55-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
99%953 patients5/55-star benchmark: 99%
Pneumococcal Vaccination Status for Older Adults
Percentage of patients 65 years of age and older who have ever received a pneumococcal vaccine
99%142 patients5/55-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
84%103 patients4/55-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: 76% · 1,291 patients
Patients tobacco: 67% · 1,263 patients
1%122 patients1/55-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
97%150 patients4/55-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…
98%522 patients4/55-star benchmark: 100%
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% · 952 patients
0%952 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
6 suppliers16 claims16 services$44.01 avg. paid by Medicare
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens V2203
Other-Vision, Hearing, and Speech Services · category OC000N
3 suppliers13 claims25 services$21.82 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 14

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

CURT S RALSTROM DDS,MS
Dentist (Pediatric Dentistry)
39400 GARFIELD RD, SUITE 200
CLINTON TOWNSHIP, MI 48038
Macomb County (586) 286-0700
OPTICAL GALLERY, INC.
Durable Medical Equipment & Medical Supplies
39400 GARFIELD RD, SUITE 102
CLINTON TOWNSHIP, MI 48038
Macomb County (586) 792-7320
ROBERT THOMAS PLUNKETT DDS,MS
Dentist (Orthodontics and Dentofacial Orthopedics)
39400 GARFIELD RD, SUITE 200
CLINTON TOWNSHIP, MI 48038
Macomb County (586) 286-0700
DR. JERRY S FAGELMAN MD
Ophthalmology
39400 GARFIELD RD, SUITE 103
CLINTON TOWNSHIP, MI 48038
Macomb County (586) 286-6550
JEFFREY S DAULTON DDS
Dentist (Pediatric Dentistry)
39400 GARFIELD RD, SUITE 200
CLINTON TOWNSHIP, MI 48038
Macomb County (586) 286-0700
DR. RENEE D FRASER DDS
Dentist (Pediatric Dentistry)
39400 GARFIELD RD, SUITE 200
CLINTON TOWNSHIP, MI 48038
Macomb County (586) 286-0700
MARTIN J MAKOWSKI DDS
Dentist (Pediatric Dentistry)
39400 GARFIELD RD, SUITE 200
CLINTON TOWNSHIP, MI 48038
Macomb County (586) 286-0700
NICHOLAS LEONE, M.D., P.C.
Ophthalmology
39400 GARFIELD RD, SUITE 103
CLINTON TWP, MI 48038
Macomb County (586) 286-6550

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 Nicholas Leone's NPI number?

The NPI number for Nicholas Leone is 1487735858. It was assigned to this individual provider in the NPPES registry on October 18, 2006.

Where is Nicholas Leone located?

Nicholas Leone practices at 39400 Garfield Rd Suite 103, Clinton Township, MI 48038. The listed phone number is (586) 286-6550.

What is Nicholas Leone's specialty?

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

Is Nicholas Leone enrolled in Medicare?

Yes. Nicholas Leone 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 Nicholas Leone accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Meridian, Blue Cross Blue Shield of Michigan Mutual Insurance Company and McLaren Health Plan Community and 1 other insurer list Nicholas Leone 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 Nicholas Leone affiliated with any hospitals?

According to CMS data, Nicholas Leone is affiliated with Mckenzie Health System.

When was this NPI record last updated?

The NPPES record for Nicholas Leone was last updated on July 8, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 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.