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DR. SEAN MICHAEL ROONEY M.D., PH.D.
NPI 1952350159
Ophthalmology in Marquette, MI

Active since May 08, 2006PECOS EnrolledAccepts Medicare Assignment
1414 W FAIR AVE, SUITE 150, MARQUETTE, MI 49855(906) 226-2531(906) 226-7555 Get Directions Write a Review

NPPES record last updated: December 29, 2009. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Dr. Sean Michael Rooney M.d., Ph.d. NPPES

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

DR. SEAN MICHAEL ROONEY M.D., PH.D. (NPI 1952350159) is an individual ophthalmology provider in Marquette, Michigan, licensed in Michigan (4301079243) and active in the NPI registry since May 2006. He is enrolled in Medicare PECOS, is affiliated with Baraga County Memorial Hospital, and is a graduate of University Of Illinois College Of Med (chi/peor/rock/chm-urb) (1998).

NPPES Registry Identity

NPI1952350159
Entity TypeIndividualMale
Primary Taxonomy207W00000X
Provider Legal NameDR. SEAN MICHAEL ROONEYCredential: M.D., PH.D.
Location Address1414 W FAIR AVE, SUITE 150Marquette, MI 49855-2675
Mailing Address1414 W Fair Ave, Suite 150Marquette, MI 49855-2675 · (906) 226-2531 · Fax (906) 226-7555
Phone(906) 226-2531
Fax(906) 226-7555
Sole ProprietorNo
Medical School CMSUniversity Of Illinois College Of Med (chi/peor/rock/chm-urb)Graduated 1998
Enumeration DateMay 8, 2006
Last NPPES UpdateDecember 29, 2009
✔ NPI 1952350159 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOphthalmologyAllopathic & Osteopathic Physicians
Taxonomy Code207W00000X
License✔ Licensed in MI · 4301079243
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.

1414 W FAIR AVE, Marquette, MI 49855
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Other Identifiers 3

Medicare UPINH60140MI
Medicaid4571975MI
Medicare PINN82880001MI

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross Blue Shield of Michigan Mutual Insurance Company, Providence Health Plan.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. Sean Michael Rooney M.d., Ph.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 ID3577450220
PECOS Enrollment IDI20040304000169
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 14

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, faricimab-svoa, 0.1 mg J2777
Faricimab-svoa is a medication given through an injection into the eye to treat certain eye conditions. The 0.1 mg dosage helps control disease progression, improving vision and eye health. The procedure is done by a healthcare professional.
10,440 services30 patients
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.
414 services412 patients
Imaging of retina 92134
Imaging of the retina is a non-invasive procedure that captures detailed images of your eye's interior. This helps detect conditions like macular degeneration or retinal detachment. It's painless and takes only a few minutes.
381 services121 patients
Measurement of corneal curvature and depth of eye 92136
This procedure measures the shape and depth of your eye, specifically the cornea, the clear front surface. It helps in diagnosing conditions, planning for surgeries, or fitting contact lenses. It's non-invasive and painless.
381 services150 patients
Injection of drug into eye 67028
An injection into the eye is a procedure where a medication is delivered directly into your eye to treat various conditions. A local anesthetic is applied to numb the eye, ensuring minimal discomfort. The drug helps manage diseases like macular degeneration or diabetic retinopathy.
291 services67 patients
Injection, aflibercept, 1 mg J0178
Aflibercept injection is a treatment for certain eye conditions that affect vision. It works by blocking abnormal blood vessel growth and leakage in the eye, which can cause vision loss. The medication is administered directly into the eye by a healthcare professional.
290 services28 patients

Hospital Affiliations CMS Care Compare 2

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

Baraga County Memorial Hospital

Critical Access Hospitals · L' Anse, MI
OwnershipGovernment - Local
CMS Certification Number231307
Location18341 Us Highway 41L' Anse, MI 49946 · Baraga County
Emergency services

Bell Hospital

Critical Access Hospitals · Ishpeming, MI
OwnershipProprietary
CMS Certification Number231321
Location901 Lakeshore DriveIshpeming, MI 49849 · Marquette County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 49855 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
$126.15 typical visit price
range $54.34 – $166.68
Typical copayment $31.53 (range $13.58 – $41.67)
Most-billed visit code 99204
Established Patient
$68.07 typical visit price
range $17.09 – $135.40
Typical copayment $17.01 (range $4.27 – $33.85)
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

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.
100%1,568 patients5/55-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…
4%24 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.
100%309 patients5/55-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.
89%1,905 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…
88%1,905 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…
0%1,905 patients1/55-star benchmark: 79%
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 4

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
2 suppliers37 claims37 services$45.41 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
2 suppliers15 claims28 services$37.49 avg. paid by Medicare
Spherocylinder, trifocal, plano to plus or minus 4.00d sphere, .12-2.00d cylinder, per lens V2303
Other-Vision, Hearing, and Speech Services · category OC000N
1 supplier30 claims59 services$48.83 avg. paid by Medicare
U-v lens, per lens V2755
Other-Vision, Hearing, and Speech Services · category OC000N
1 supplier44 claims87 services$10.77 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 20

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

MR. KIRK W MATTHEWS LMSW
Social Worker (Clinical)
1414 W FAIR AVE
MARQUETTE, MI 49855
Marquette County (906) 774-3300
MR. STEVEN M GUALDONI PAC
Physician Assistant
1414 W FAIR AVE, STE 332
MARQUETTE, MI 49855
Marquette County (906) 225-3922
PENINSULA PHARMACY INC
Pharmacy (Community/Retail Pharmacy)
1414 W FAIR AVE, SUITE 133
MARQUETTE, MI 49855
Marquette County (906) 225-3902
BOBBY Z JOSEPH M.D.
Allergy & Immunology
1414 W FAIR AVE, SUITE 216
MARQUETTE, MI 49855
Marquette County (906) 225-4725
NATHAN SAMUEL TAYLOR MD
Plastic Surgery (Surgery of the Hand)
1414 W FAIR AVE, SUITE 190
MARQUETTE, MI 49855
Marquette County (906) 225-1321
DR. PUSHPAMAL NAYANANGA SAMARARATNE MD
Student in an Organized Health Care Education/Training Program
1414 W FAIR AVE, SUITE 24
MARQUETTE, MI 49855
Marquette County (906) 225-3864
RODNEY RIESLAND NP
Nurse Practitioner (Primary Care)
1414 W FAIR AVE, STE 344
MARQUETTE, MI 49855
Marquette County (906) 225-3910
MANSOUR MIKY M.D.
Physical Medicine & Rehabilitation
1414 W FAIR AVE, SUITE 204
MARQUETTE, MI 49855
Marquette County (906) 225-7740

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 Sean Rooney's NPI number?

The NPI number for Sean Rooney is 1952350159. It was assigned to this individual provider in the NPPES registry on May 8, 2006.

Where is Sean Rooney located?

Sean Rooney practices at 1414 W Fair Ave Suite 150, Marquette, MI 49855. The listed phone number is (906) 226-2531.

What is Sean Rooney's specialty?

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

Is Sean Rooney enrolled in Medicare?

Yes. Sean Rooney 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 Sean Rooney accept?

Health plans from Blue Cross Blue Shield of Michigan Mutual Insurance Company and Providence Health Plan list Sean Rooney 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 Sean Rooney affiliated with any hospitals?

According to CMS data, Sean Rooney is affiliated with Baraga County Memorial Hospital and Bell Hospital.

When was this NPI record last updated?

The NPPES record for Sean Rooney was last updated on December 29, 2009. NPI Profile syncs with the weekly NPPES data releases published by CMS.