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MICHAEL GILMOUR MCCLURE MD
NPI 1821106535
Orthopaedic Surgery in Binghamton, NY

Active since August 25, 2006PECOS EnrolledAccepts Medicare Assignment
81.31/100
CMS Quality Rating
65 PENNSYLVANIA AVENUE, ORTHOPEDIC ASSOCIATES, BINGHAMTON, NY 13903(607) 723-5393(607) 771-0803 Get Directions Write a Review

NPPES record last updated: March 24, 2021. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Michael Gilmour Mcclure Md NPPES

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

MICHAEL GILMOUR MCCLURE MD (NPI 1821106535) is an individual orthopaedic surgery provider in Binghamton, New York, licensed in New York (134605) and active in the NPI registry since August 2006. He is enrolled in Medicare PECOS, is affiliated with Our Lady Of Lourdes Memorial Hospital, Inc, and is a graduate of University Of Pittsburgh School Of Medicine (1971).

NPPES Registry Identity

NPI1821106535
Entity TypeIndividualMale
Primary Taxonomy207X00000X
Provider Legal NameMICHAEL GILMOUR MCCLURECredential: MD
Location Address65 PENNSYLVANIA AVENUE, ORTHOPEDIC ASSOCIATESBinghamton, NY 13903
Mailing Address65 Pennsylvania Ave, Orthopedic AssociatesBinghamton, NY 13903 · (607) 723-5393 · Fax (607) 771-0803
Phone(607) 723-5393
Fax(607) 771-0803
Sole ProprietorNo
Medical School CMSUniversity Of Pittsburgh School Of MedicineGraduated 1971
Enumeration DateAugust 25, 2006
Last NPPES UpdateMarch 24, 2021
NPPES CertifiedMarch 24, 2021
✔ NPI 1821106535 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyOrthopaedic SurgeryAllopathic & Osteopathic Physicians
Taxonomy Code207X00000X
License✔ Licensed in NY · 134605
Definition
An orthopaedic surgeon is trained in the preservation, investigation and restoration of the form and function of the extremities, spine and associated structures by medical, surgical and physical means. An orthopaedic surgeon is involved with the care of patients whose musculoskeletal problems include congenital deformities, trauma, infections, tumors, metabolic disturbances of the musculoskeletal system, deformities, injuries and degenerative diseases of the spine, hands, feet, knee, hip, shoulder and elbow in children and adults. An orthopaedic surgeon is also concerned with primary and secondary muscular problems and the effects of central or peripheral nervous system lesions of the musculoskeletal system.
Also ListedOrthopaedic Surgery · Foot and Ankle SurgeryTaxonomy 207XX0004X · License 134605 (NY)
65 PENNSYLVANIA AVENUE, Binghamton, NY 13903
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Other Identifiers 1

Medicaid00437458NY

Accepted Insurance

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

Michael Gilmour Mcclure Md 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 ID1557301850
PECOS Enrollment IDI20110317000464
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 4

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 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.
151 services86 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.
43 services31 patients
New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204
This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.
25 services25 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.
15 services11 patients

Hospital Affiliations CMS Care Compare 2

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

Our Lady Of Lourdes Memorial Hospital, Inc

Acute Care Hospitals · Binghamton, NY
2/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number330011
Location169 Riverside DriveBinghamton, NY 13905 · Broome County
Emergency services Birthing friendly

United Health Services Hospitals, Inc

Acute Care Hospitals · Binghamton, NY
2/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number330394
Location10-42 Mitchell AvenueBinghamton, NY 13903 · Broome County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 13903 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
$84.93 typical visit price
range $54.87 – $166.88
Typical copayment $21.23 (range $13.71 – $41.72)
Most-billed visit code 99203
Established Patient
$68.57 typical visit price
range $17.54 – $136.14
Typical copayment $17.14 (range $4.38 – $34.03)
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.

81.31/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality73.57
Promoting Interoperability95
Improvement Activities40
Cost64.87

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.

ORTHOPEDIC ASSOCIATES OF 65 PENNA AVENUE, PC
Orthopaedic Surgery
65 PENNSYLVANIA AVENUE
BINGHAMTON, NY 13903
Broome County (607) 723-5393
TATYANA BOYKO FNP
Nurse Practitioner
65 PENNSYLVANIA AVENUE
BINGHAMTON, NY 13903
Broome County (607) 723-5393
ERIC ARNOLD SEYBOLD MD
Orthopaedic Surgery
65 PENNSYLVANIA AVENUE, ORTHOPEDIC ASSOCIATES
BINGHAMTON, NY 13903
Broome County (607) 723-5393
DOUGLAS ROBERT KERR MD
Orthopaedic Surgery
65 PENNSYLVANIA AVENUE
BINGHAMTON, NY 13903
Broome County (607) 723-5393
LAURENCE UNDERWOOD SCHENK MD
Orthopaedic Surgery (Orthopaedic Surgery of the Spine)
65 PENNSYLVANIA AVENUE, ORTHOPEDIC ASSOCIATES
BINGHAMTON, NY 13903
Broome County (607) 723-5393

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 Michael Mcclure's NPI number?

The NPI number for Michael Mcclure is 1821106535. It was assigned to this individual provider in the NPPES registry on August 25, 2006.

Where is Michael Mcclure located?

Michael Mcclure practices at 65 Pennsylvania Avenue Orthopedic Associates, Binghamton, NY 13903. The listed phone number is (607) 723-5393.

What is Michael Mcclure's specialty?

The primary specialty registered for this NPI is Orthopaedic Surgery with taxonomy code 207X00000X.

Is Michael Mcclure enrolled in Medicare?

Yes. Michael Mcclure 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 Michael Mcclure accept?

Health plans from Ambetter Health, Ambetter Health of Delaware and Ambetter from Buckeye Health Plan list Michael Mcclure 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 Michael Mcclure affiliated with any hospitals?

According to CMS data, Michael Mcclure is affiliated with Our Lady Of Lourdes Memorial Hospital, Inc and United Health Services Hospitals, Inc.

When was this NPI record last updated?

The NPPES record for Michael Mcclure was last updated on March 24, 2021. 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.