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MARK E BERNTHAL OD
NPI 1811991391
Optometrist in St Clair Shores, MI

Active since June 13, 2005PECOS EnrolledAccepts Medicare Assignment
75.7/100
CMS Quality Rating
21711 GREATER MACK AVE, ST CLAIR SHORES, MI 48080(586) 774-0393 Get Directions Write a Review

NPPES record last updated: June 11, 2008. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Mark E Bernthal Od NPPES

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

MARK E BERNTHAL OD (NPI 1811991391) is an individual optometrist in St Clair Shores, Michigan, licensed in Michigan (4901002685) and active in the NPI registry since June 2005. He is enrolled in Medicare PECOS and is a graduate of Illinois College Of Optometry At Chicago (1979).

NPPES Registry Identity

NPI1811991391
Entity TypeIndividualMale
Primary Taxonomy152W00000X
Provider Legal NameMARK E BERNTHALCredential: OD
Location Address21711 GREATER MACK AVESt Clair Shores, MI 48080-2418
Mailing Address21711 Greater Mack AveSt Clair Shores, MI 48080-2418 · (586) 774-0393
Phone(586) 774-0393
Sole ProprietorNo
Medical School CMSIllinois College Of Optometry At ChicagoGraduated 1979
Enumeration DateJune 13, 2005
Last NPPES UpdateJune 11, 2008
✔ NPI 1811991391 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOptometristEye and Vision Services Providers
Taxonomy Code152W00000X
License✔ Licensed in MI · 4901002685
Definition
Doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye. An optometrist has completed pre-professional undergraduate education in a college or university and four years of professional education at a college of optometry, leading to the doctor of optometry (O.D.) degree. Some optometrists complete an optional residency in a specific area of practice. Optometrists are eye health care professionals state-licensed to diagnose and treat diseases and disorders of the eye and visual system.
21711 GREATER MACK AVE, St Clair Shores, MI 48080
Open in Google Maps ↗

Other Identifiers 4

Other410016688MI · Medicare Railroad
Medicare PIN0E06612MI
Other0218080001MI · Dmerc
Medicare UPINT33221MI

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Care Network of Michigan, Blue Cross and Blue Shield of Louisiana, Blue Cross and Blue Shield of Montana 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

Mark E Bernthal Od 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 ID5698969129
PECOS Enrollment IDI20101028001413
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 2

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.
84 services84 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.
14 services13 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 48080 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.

75.7/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality99.55
Improvement Activities40
Cost19.61

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…
77%30 patients4/55-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…
100%30 patients5/55-star benchmark: 100%
Closing the Referral Loop: Receipt of Specialist Report
Percentage of patients with referrals, regardless of age, for which the referring provider receives a report from the provider to whom the patient was referred
46%24 patients2/55-star benchmark: 95%
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
100%122 patients5/55-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.
100%2,373 patients5/55-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
92%375 patients4/55-star benchmark: 99%
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.
96%1,631 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.
100%3,007 patients5/55-star benchmark: 100%
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 tobacco: 93% · 209 patients
98%209 patients
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
100%28 patients5/55-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…
99%3,007 patients4/55-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…
98%3,007 patients5/55-star benchmark: 79%
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% · 364 patients
0%364 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.

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.

RICHARD C MERTZ JR MD PC
Clinic/Center (Ambulatory Surgical)
21711 GREATER MACK AVE
SAINT CLAIR SHORES, MI 48080
Macomb County (586) 774-0393
JAMES W KLEIN MD
Ophthalmology
21711 GREATER MACK AVE
ST CLAIR SHORES, MI 48080
Macomb County (586) 774-0393
MARIANN M CHANNELL MD
Ophthalmology
21711 GREATER MACK AVE
ST CLAIR SHORES, MI 48080
Macomb County (586) 774-0393
ST CLAIR SHORES MI OPHTHALMOLOGY ASC LLC
Clinic/Center (Ambulatory Surgical)
21711 GREATER MACK AVE
SAINT CLAIR SHORES, MI 48080
Macomb County (586) 774-0393
RICHARD C MERTZ JR MD PC
Ophthalmology
21711 GREATER MACK AVE
ST CLAIR SHORES, MI 48080
Macomb County (586) 774-0393
SHOREPOINTE OPTICAL INC
Eyewear Supplier
21711 GREATER MACK AVE
SAINT CLAIR SHORES, MI 48080
Macomb County (586) 774-9320

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 Mark Bernthal's NPI number?

The NPI number for Mark Bernthal is 1811991391. It was assigned to this individual provider in the NPPES registry on June 13, 2005.

Where is Mark Bernthal located?

Mark Bernthal practices at 21711 Greater Mack Ave, St Clair Shores, MI 48080. The listed phone number is (586) 774-0393.

What is Mark Bernthal's specialty?

The primary specialty registered for this NPI is Optometrist with taxonomy code 152W00000X.

Is Mark Bernthal enrolled in Medicare?

Yes. Mark Bernthal 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 Mark Bernthal accept?

Health plans from Blue Care Network of Michigan, Blue Cross Blue Shield of Michigan Mutual Insurance Company, Blue Cross Blue Shield of Wyoming, Blue Cross and Blue Shield of Louisiana and Blue Cross and Blue Shield of Montana and 4 other insurers list Mark Bernthal 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 Mark Bernthal was last updated on June 11, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 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.