PHILIP CLIFTON
NPI 1598126849
Physician Assistant in Royal Oak, MI
NPI Status: Active since March 15, 2016
Contact Information
221 S MAIN ST STE 201
ROYAL OAK, MI
ZIP 48067
Phone: (248) 398-6459
Fax: (248) 398-4770
- Individual
- Male
- Physician Assistant
- Accepts Insurance
- PECOS Enrolled
- Medicare Quality Reporting
About PHILIP CLIFTON
This page provides the complete NPI Profile along with additional information for Philip Clifton, a primary care provider established in Royal Oak, Michigan with a medical specialization in Physician Assistant. The healthcare provider is registered in the NPI registry with number 1598126849 assigned on March 2016. The practitioner's primary taxonomy code is 363A00000X with license number 5601007339 (MI). The provider is registered as an individual and his NPI record was last updated 10 years ago.
- NPI
- 1598126849
- Provider Name
- PHILIP CLIFTON
- Gender
- Male
- Entity Type
- Individual
- Location Address
- 221 S MAIN ST STE 201 ROYAL OAK, MI 48067
- Location Phone
- (248) 398-6459
- Location Fax
- (248) 398-4770
- Mailing Address
- 221 S MAIN ST STE 201 ROYAL OAK, MI 48067
- Mailing Phone
- (248) 398-6459
- Mailing Fax
- (248) 398-4770
- Is Sole Proprietor?
- Yes
- Enumeration Date
- 03-15-2016
- Last Update Date
- 03-15-2016
- Code Navigator
A primary care provider (PCP) like Philip Clifton sees people with common medical problems. The primary care provider might be a doctor, physician assistant, nurse practitioner or clinic that are usually involved in your long-term care. A PCP might provide preventive care, treat common medical conditions, identify urgent medical problems and refer you to specialists when necessary. Primary care is usually provided in an outpatient facility but if you are admitted to a hospital your PCP may assist in your care. The most common medical conditions seen by primary care providers are: hypertension, upper respiratory tract infections, depression or anxiety, back pain, arthritis, dermatitis, diabetes, urinary tract infections, etc .
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
Physician Assistant
- Taxonomy Code
- 363A00000X
- Type
- Physician Assistants & Advanced Practice Nursing Providers
- License No.
- 5601007339
- License State
- MI
- Taxonomy Description
- A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Blue Cross� Local HMO Bronze Extra - HMO
- Blue Cross� Local HMO Bronze Secure - HMO
- Blue Cross� Local HMO Silver Extra - HMO
- Blue Cross� Local HMO Silver Saver - HMO
- Blue Cross� Preferred HMO Bronze Extra - HMO
- Blue Cross� Preferred HMO Bronze Saver HSA - HMO
- Blue Cross� Preferred HMO Bronze Secure - HMO
- Blue Cross� Preferred HMO Gold - HMO
- Blue Cross� Preferred HMO Gold Extra - HMO
- Blue Cross� Preferred HMO Silver - HMO
- Blue Cross� Preferred HMO Silver Extra - HMO
- Blue Cross� Preferred HMO Silver Saver - HMO
- Blue Cross� Preferred HMO Value - HMO
- Blue Cross� Select HMO Bronze Extra - HMO
- Blue Cross� Select HMO Bronze Saver HSA - HMO
- Blue Cross� Select HMO Bronze Secure - HMO
- Blue Cross� Select HMO Silver - HMO
- Blue Cross� Select HMO Silver Extra - HMO
- Blue Cross� Select HMO Silver Saver - HMO
- Blue Cross� Select HMO Value - HMO
- Blue Cross� Premier PPO Bronze Extra - PPO
- Blue Cross� Premier PPO Bronze Saver HSA - PPO
- Blue Cross� Premier PPO Bronze Secure - PPO
- Blue Cross� Premier PPO Gold - PPO
- Blue Cross� Premier PPO Gold Extra - PPO
- Blue Cross� Premier PPO Silver - PPO
- Blue Cross� Premier PPO Silver Extra - PPO
- Blue Cross� Premier PPO Silver Saver HSA - PPO
- Blue Cross� Premier PPO Value - PPO
- MHP Bronze - HMO
- MHP Bronze Saver (Expanded) - HMO
- MHP Expanded Bronze Standard - HMO
- MHP Gold - HMO
- MHP Gold Standard - HMO
- MHP Silver Exchange - HMO
- MHP Silver Exchange Rewards - HMO
- MHP Silver Standard - HMO
- MHP Young Adult/Catastrophic - HMO
- MyPriority Balanced Silver - HMO
- MyPriority Balanced Silver Bronson Healthcare Partners - HMO
- MyPriority Balanced Silver Corewell Health West Michigan Network - HMO
- MyPriority Balanced Silver Corewell Health West Michigan Network (Allegan, Barry) - HMO
- MyPriority Balanced Silver Southeast Michigan Network - HMO
- MyPriority Balanced Silver Trinity Health East Network - HMO
- MyPriority Enhanced Gold Bronson Healthcare Partners - HMO
- MyPriority Enhanced Gold Corewell Health West Michigan Network - HMO
- MyPriority Enhanced Gold Corewell Health West Michigan Network (Allegan, Barry) - HMO
- MyPriority Enhanced Gold Southeast Michigan Network - HMO
- MyPriority Enhanced Gold Trinity Health East Network - HMO
- MyPriority Premier Silver - HMO
- MyPriority Premier Silver Bronson Healthcare Partners - HMO
- MyPriority Premier Silver Corewell Health West Michigan Network - HMO
- MyPriority Premier Silver Corewell Health West Michigan Network (Allegan, Barry) - HMO
- MyPriority Premier Silver Trinity Health East Network - HMO
- MyPriority Standard Bronze - HMO
- MyPriority Standard Bronze - Bronson Healthcare Partners - HMO
- MyPriority Standard Bronze - Corewell Health West Michigan Network - HMO
- MyPriority Standard Bronze - Corewell Health West Michigan Network (Allegan, Barry) - HMO
- Connect 1500 Gold - EPO
- Connect 6000 Silver - EPO
- Connect 9800 Bronze - EPO
- HSA Qualified 7500 Bronze - Choice Network - EPO
- HSA-E Qualified 7500 Bronze - Signature Network - EPO
- Providence Oregon Standard Bronze Plan - Choice Network - EPO
- Providence Oregon Standard Bronze Plan - Signature Network - EPO
- Providence Oregon Standard Gold Plan - Choice Network - EPO
- Providence Oregon Standard Gold Plan - Signature Network - EPO
- Providence Oregon Standard Silver Plan - Choice Network - EPO
- Providence Oregon Standard Silver Plan - Signature Network - EPO
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Medicare Participation & PECOS Enrollment Status
Philip Clifton 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.
Established patient custodial care facility, group care, or assisted living visit, typically 15 minutes
Established patient custodial care facility, group care, or assisted living visit, typically 25 minutes
Established patient custodial care facility, group care, or assisted living visit, typically 40 minutes
Follow-up nursing facility visit per day, typically 10 minutes
Follow-up nursing facility visit per day, typically 15 minutes
Follow-up nursing facility visit per day, typically 25 minutes
Initial nursing facility visit per day, typically 25 minutes
Initial nursing facility visit per day, typically 35 minutes
This is a routine 15-minute visit for patients residing in care facilities like nursing homes or assisted living. During this visit, healthcare providers review the patient's health, manage medications, and address any concerns or changes in condition. It ensures continuous, quality care.
This service was performed 13 times for 12 patientsThis refers to a routine medical visit for an established patient living in a group care facility, custodial care, or assisted living. The visit typically lasts 25 minutes and includes a check-up and discussion about ongoing healthcare needs.
This service was performed 55 times for 32 patientsThis is a routine visit for established patients residing in care facilities like nursing homes or assisted living. The visit typically lasts about 40 minutes, during which the healthcare provider checks your overall health, discusses any concerns, and adjusts care plans as needed.
This service was performed 30 times for 20 patientsA follow-up nursing facility visit per day typically lasts about 10 minutes. This service involves a healthcare professional checking on your health status, answering any questions you may have, and monitoring your progress. This routine check ensures your recovery is on track and any concerns are addressed promptly.
This service was performed 66 times for 37 patientsA follow-up nursing facility visit per day is a daily check-up service provided by healthcare professionals. It lasts around 15 minutes and involves assessing your health status, monitoring your recovery progress, and addressing any concerns you may have about your health or treatment.
This service was performed 325 times for 131 patientsA follow-up nursing facility visit per day is a daily check-in by a healthcare professional. This 25-minute visit typically involves monitoring your health progress, addressing any concerns, and adjusting treatment plans as necessary. It's a vital part of ensuring your ongoing wellbeing.
This service was performed 187 times for 87 patientsAn initial nursing facility visit is a daily check-up to monitor your health status. This service, lasting typically 25 minutes, involves a nurse assessing your overall wellbeing, discussing concerns, and updating your care plan as needed.
This service was performed 19 times for 19 patientsAn initial nursing facility visit per day is a service where a healthcare professional spends about 35 minutes assessing a patient's health status. This includes reviewing medical history, conducting a physical exam, and developing a care plan based on the patient's needs.
This service was performed 36 times for 36 patientsPhysician 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 48067 ZIP code area.
New Patients Visit Costs *
The most utilized procedure code for new patients office visits is 99203
- Average New Patient Price $90.76
- Minimum New Patient Price $58.04
- Maximum New Patient Price $177.36
- Average New Patient Copayment $22.69
- Minimum New Patient Copayment $14.51
- Maximum New Patient Copayment $44.34
Established Patients Visit Costs *
The most utilized procedure code for established patients office visits is 99213
- Average Established Patient Price $72.38
- Minimum Established Patient Price $18.32
- Maximum Established Patient Price $143.49
- Average Established Patient Copayment $18.09
- Minimum Established Patient Copayment $4.58
- Maximum Established Patient Copayment $35.87
* 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.
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 | 99% | 154 |
| 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 | ||
| Dementia Associated Behavioral and Psychiatric Symptoms Screening and Management | 100% | 157 |
| Percentage of patients with dementia for whom there was a documented symptoms screening* for behavioral and psychiatric symptoms, including depression, AND for whom, if symptoms screening was positive, there was also documentation of recommendations for symptoms management in the last 12 months | ||
| Dementia: Caregiver Education and Support | 77% | 157 |
| Percentage of patients with dementia whose caregiver(s)* were provided with education** on dementia disease management and health behavior changes AND were referred to additional resources*** for support in the last 12 months | ||
| Dementia: Functional Status Assessment | 100% | 157 |
| Percentage of patients with dementia for whom an assessment of functional status* was performed at least once in the last 12 months | ||
| Dementia: Safety Concerns Screening and Mitigation Recommendations or Referral for Patients with Dementia | 100% | 157 |
| Percentage of patients with dementia or their caregiver(s) for whom there was a documented safety concerns screening * in two domains of risk: 1) dangerousness to self or others and 2) environmental risks; and if safety concerns screening was positive in the last 12 months, there was documentation of mitigation recommendations, including but not limited to referral to other resources or orders for home safety evaluation | ||
| 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. | ||
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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 1598126849, we treat the final digit (9) 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 71. The final step is to find the difference between that total and the next multiple of ten (80 - 71 = 9).
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.
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.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 71 is 80. The difference is the calculated check digit.
Other Providers at the Same Location
The following 14 providers are registered at the same or a nearby location.
ROYAL OAK, MI 48067
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1598126849, enumerated as an "individual" on March 15, 2016.
The provider is located at 221 S MAIN ST STE 201 ROYAL OAK, MI 48067 and the phone number is (248) 398-6459.
Physician Assistant with taxonomy code 363A00000X.
The provider might be accepting Accepts: Blue Care Network of Michigan, Blue Cross Blue. Please consult your insurance carrier or call the provider to verify.
