DR. DAVID A MCLAIN M.D.
NPI 1689614737
Internal Medicine - Rheumatology in Birmingham, AL

Active since June 07, 2006PECOS EnrolledAccepts Medicare Assignment
94.05/100
CMS Quality Rating
2229 CAHABA VALLEY DR, BIRMINGHAM, AL 35242(205) 991-8996(205) 991-8997 Get Directions Write a Review

NPPES record last updated: October 21, 2020. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Oct 21, 2020, Feb 3, 2017 (2 updates tracked since 2017).

About Dr. David A Mclain M.d. NPPES

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

DR. DAVID A MCLAIN M.D. (NPI 1689614737) is an individual rheumatology provider in Birmingham, Alabama, licensed in Alabama (9639) and active in the NPI registry since June 2006. He is enrolled in Medicare PECOS and is a graduate of Tulane University School Of Medicine (1974).

NPPES Registry Identity

NPI1689614737
Entity TypeIndividualMale
Primary Taxonomy207RR0500X
Provider Legal NameDR. DAVID A MCLAINCredential: M.D.
Location Address2229 CAHABA VALLEY DRBirmingham, AL 35242-2602
Mailing Address2229 Cahaba Valley DrBirmingham, AL 35242-2602 · (205) 991-8996 · Fax (205) 997-8997
Fax(205) 991-8997
Sole ProprietorNo
Medical School CMSTulane University School Of MedicineGraduated 1974
Enumeration DateJune 7, 2006
Last NPPES UpdateOctober 21, 20202 updates tracked since enumeration
NPPES CertifiedOctober 21, 2020
NPI 1689614737 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyInternal Medicine · RheumatologyAllopathic & Osteopathic Physicians
Taxonomy Code207RR0500X
License Licensed in AL · 9639
Definition
An internist who treats diseases of joints, muscle, bones and tendons. This specialist diagnoses and treats arthritis, back pain, muscle strains, common athletic injuries and collagen diseases.
2229 CAHABA VALLEY DR, Birmingham, AL 35242

Accepted 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. David A Mclain 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 ID4183646094
PECOS Enrollment IDI20101018000575
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 11

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.

Injection, denosumab, 1 mg J0897
Denosumab is a medication given via injection to strengthen your bones. It works by slowing down the cells that break down bone, improving bone density and reducing the risk of fractures. It's often used for osteoporosis treatment.
5,580 services65 patients
Injection, triamcinolone acetonide, not otherwise specified, 10 mg J3301
Triamcinolone acetonide is a medication used to reduce inflammation in the body. It's given as a 10 mg injection for conditions like allergies, arthritis, or skin problems. The injection helps to decrease swelling, redness, and itching.
858 services124 patients
Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
614 services362 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.
257 services158 patients
Aspiration and/or injection of fluid from large joint 20610
This procedure involves using a needle to remove (aspiration) or introduce (injection) fluid into a large joint like the knee or hip. It can help diagnose conditions, relieve discomfort, or deliver medication directly to the joint.
211 services118 patients
Administration of non-hormonal anti-neoplastic chemotherapy under skin or into muscle 96401
This procedure involves giving anti-cancer drugs, which don't contain hormones, into the muscle or under the skin. These drugs help to stop the growth of cancer cells. The process is usually quick and done by a healthcare professional.
111 services69 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 35242 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
$122.31 typical visit price
range $52.65 – $161.63
Typical copayment $30.57 (range $13.16 – $40.40)
Most-billed visit code 99204
Established Patient
$93.72 typical visit price
range $16.56 – $131.65
Typical copayment $23.43 (range $4.14 – $32.91)
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.

94.05/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality100
Promoting Interoperability99
Improvement Activities40
Cost81

Reported Quality Measures

Care Plan
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…
83%931 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.
92%5,722 patients4/55-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.
89%5,628 patients4/55-star benchmark: 100%
Health Information Exchange
The MIPS eligible clinician that transitions or refers their patient to another setting of care or health care clinician (1) uses CEHRT to create a summary of care record; and (2) electronically transmits such summary to a receiving health care clinician for…
20%85 patients1/55-star benchmark: 98%
Medication Reconciliation
The MIPS eligible clinician performs medication reconciliation for at least one transition of care in which the patient is transitioned into the care of the MIPS eligible clinician.
88%91 patients4/55-star benchmark: 100%
Osteoarthritis (OA): Function and Pain Assessment
Percentage of patient visits for patients aged 21 years and older with a diagnosis of osteoarthritis (OA) with assessment for function and pain
98%3,005 patients4/55-star benchmark: 100%
Pain Assessment and Follow-Up
Percentage of visits for patients aged 18 years and older with documentation of a pain assessment using a standardized tool(s) on each visit AND documentation of a follow-up plan when pain is present
96%5,722 patients4/55-star benchmark: 100%
Patient-Specific Education
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.
99%1,496 patients4/55-star benchmark: 100%
Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan
Percentage of patients aged 18 years and older with a BMI documented during the current encounter or during the previous twelve months AND with a BMI outside of normal parameters, a follow-up plan is documented during the encounter or during the previous…
19%2,407 patients1/55-star benchmark: 97%
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
74%1,354 patients4/55-star benchmark: 88%
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…
69%1,496 patients3/55-star benchmark: 100%
Rheumatoid Arthritis (RA): Functional Status Assessment
Percentage of patients aged 18 years and older with a diagnosis of rheumatoid arthritis (RA) for whom a functional status assessment was performed at least once within 12 months
100%545 patients5/55-star benchmark: 100%
Secure Messaging
For at least one unique patient seen by the MIPS eligible clinician during the performance period, a secure message was sent using the electronic messaging function of CEHRT to the patient (or the patient-authorized representative), or in response to a secure…
1%1,496 patients1/55-star benchmark: 79%
Urinary Incontinence: Assessment of Presence or Absence of Urinary Incontinence in Women Aged 65 Years and Older
Percentage of female patients aged 65 years and older who were assessed for the presence or absence of urinary incontinence within 12 months
100%729 patients5/55-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+: 21% · 883 patients
28%883 patients1/55-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 6

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Injection, immune globulin (privigen), intravenous, non-lyophilized (e.g., liquid), 500 mg J1459
Treatment-Injections and Infusions (nononcologic) · category RI008N
2 suppliers15 claims1,170 services$36.36 avg. paid by Medicare
Standard wheelchair K0001
DME-Wheelchairs · category DD000N
3 suppliers17 claims19 services$23.05 avg. paid by Medicare
Lightweight wheelchair K0003
DME-Wheelchairs · category DD000N
1 supplier17 claims17 services$34.75 avg. paid by Medicare
Heavy duty wheelchair K0006
DME-Wheelchairs · category DD000N
1 supplier17 claims17 services$47.88 avg. paid by Medicare
Elevating leg rests, pair (for use with capped rental wheelchair base) K0195
DME-Wheelchairs · category DD021N
2 suppliers22 claims22 services$8.65 avg. paid by Medicare
Power wheelchair, group 2 standard, captains chair, patient weight capacity up to and including 300 pounds K0823
DME-Wheelchairs · category DD009N
1 supplier11 claims11 services$136.80 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 6

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

Nurse Practitioner (Family)
2229 CAHABA VALLEY DR
BIRMINGHAM, AL 35242
Nurse Practitioner
2229 CAHABA VALLEY DR
BIRMINGHAM, AL 35242
Specialist
2229 CAHABA VALLEY DR
BIRMINGHAM, AL 35242
Specialist
2229 CAHABA VALLEY DR
BIRMINGHAM, AL 35242
Nurse Practitioner (Family)
2229 CAHABA VALLEY DR
BIRMINGHAM, AL 35242
Nurse Practitioner
2229 CAHABA VALLEY DR
BIRMINGHAM, AL 35242

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 David Mclain's NPI number?

The NPI number for David Mclain is 1689614737. It was assigned to this individual provider in the NPPES registry on June 7, 2006.

Where is David Mclain located?

David Mclain practices at 2229 Cahaba Valley Dr, Birmingham, AL 35242. The listed phone number is (205) 991-8996.

What is David Mclain's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Rheumatology, with taxonomy code 207RR0500X.

Is David Mclain enrolled in Medicare?

Yes. David Mclain 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 David Mclain accept?

Health plans from Blue Cross and Blue Shield of Alabama and UnitedHealthcare list David Mclain 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.

When was this NPI record last updated?

The NPPES record for David Mclain was last updated on October 21, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.