CARLOS LUCERO M.D.
NPI 1023421930
Family Medicine in Gainesville, GA

Active since June 09, 2014PECOS EnrolledAccepts Medicare Assignment
79.77/100
CMS Quality Rating
597 S ENOTA DR NE, GAINESVILLE, GA 30501(770) 219-7777 Get Directions Write a Review

NPPES record last updated: November 1, 2022. Verified against the NPPES registry weekly; last sync: August 30, 2026.

Record update history: Nov 1, 2022, Oct 3, 2022, May 17, 2018 (3 updates tracked since 2018).

About Carlos Lucero M.d. NPPES

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

CARLOS LUCERO M.D. (NPI 1023421930) is an individual family medicine provider in Gainesville, Georgia, licensed in Georgia (079514) and active in the NPI registry since June 2014. He is enrolled in Medicare PECOS, is affiliated with Northeast Georgia Medical Center, Inc, and maintains 2 additional practice locations.

NPPES Registry Identity

NPI1023421930
Entity TypeIndividualMale
Primary Taxonomy207Q00000X
Provider Legal NameCARLOS LUCEROCredential: M.D.
Location Address597 S ENOTA DR NEGainesville, GA 30501-2545
Mailing AddressPo Box 742616Atlanta, GA 30374-2616 · (770) 219-8420
Sole ProprietorNo
Medical School CMSOtherGraduated 2017
Enumeration DateJune 9, 2014
Last NPPES UpdateNovember 1, 20223 updates tracked since enumeration
NPPES CertifiedNovember 1, 2022
NPI 1023421930 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License Licensed in GA · 079514
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
597 S ENOTA DR NE, Gainesville, GA 30501

Secondary Practice Locations 2

Location 1485 Highway 29 NAthens, GA 30601 · Phone (706) 353-6000
Location 24445 S Lee St Ste 105Buford, GA 30518-8806 · Phone (770) 848-9240

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

Carlos Lucero 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 ID547516502
PECOS Enrollment IDI20180703003396
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 15

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, dexamethasone sodium phosphate, 1 mg J1100
Dexamethasone sodium phosphate is a medication given via injection. It is a type of steroid that helps reduce inflammation and immune responses. It can be used to treat a variety of conditions, such as allergies, skin conditions, arthritis, and more.
340 services29 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.
317 services286 patients
Respiratory infectious agent detection by rna for severe acute respiratory syndrome coronavirus 2 (covid 19), influenza a, influenza b, and respiratory syncytial virus, upper respiratory specimen, each reported as detected or not detected 0241U
This test detects the RNA of respiratory viruses, including COVID-19, Influenza A, Influenza B, and Respiratory Syncytial Virus, in an upper respiratory specimen. The test result will report if each virus is detected or not, helping in accurate diagnosis.
144 services133 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.
137 services127 patients
Detection test by immunoassay with direct visual observation for streptococcus, group a (strep) 87880
A detection test by immunoassay for Group A Strep is a quick procedure to identify a bacterial infection in your throat. It involves taking a throat swab and applying it to a test strip, which changes color if Strep bacteria are present.
122 services110 patients
Injection, ceftriaxone sodium, per 250 mg J0696
Ceftriaxone sodium is an antibiotic injection used to treat a variety of bacterial infections. Each injection contains 250 mg of the medicine. It works by stopping the growth of bacteria in your body.
76 services18 patients

Hospital Affiliations CMS Care Compare

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

Northeast Georgia Medical Center, Inc

Acute Care Hospitals · Gainesville, GA
3/5 CMS rating
OwnershipGovernment - Local
CMS Certification Number110029
Location743 Spring StreetGainesville, GA 30501 · Hall County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 30501 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
$83.23 typical visit price
range $53.31 – $164.04
Typical copayment $20.80 (range $13.32 – $41.01)
Most-billed visit code 99203
Established Patient
$94.84 typical visit price
range $16.68 – $133.24
Typical copayment $23.71 (range $4.17 – $33.31)
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.

79.77/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality82.05
Promoting Interoperability100
Improvement Activities40
Cost50.53

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…
0%228 patients1/55-star benchmark: 100%
Colorectal Cancer Screening
Percentage of adults 50-75 years of age who had appropriate screening for colorectal cancer
3%173 patients1/55-star benchmark: 100%
Pneumococcal Vaccination Status for Older Adults
Percentage of patients 65 years of age and older who have ever received a pneumococcal vaccine
4%228 patients1/55-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…
22%291 patients1/55-star benchmark: 100%
Screening for Osteoporosis for Women Aged 65-85 Years of Age
Percentage of female patients aged 65-85 years of age who ever had a central dual-energy X-ray absorptiometry (DXA) to check for osteoporosis
4%132 patients1/55-star benchmark: 98%
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 20

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

Physician Assistant (Medical)
597 S ENOTA DR NE
GAINESVILLE, GA 30501
Family Medicine
597 S ENOTA DR NE
GAINESVILLE, GA 30501
Physician Assistant (Medical)
597 S ENOTA DR NE
GAINESVILLE, GA 30501
Physical Therapist
597 S ENOTA DR NE
GAINESVILLE, GA 30501
Physical Therapist
597 S ENOTA DR NE
GAINESVILLE, GA 30501
Physician Assistant
597 S ENOTA DR NE
GAINESVILLE, GA 30501
Physical Therapist
597 S ENOTA DR NE
GAINESVILLE, GA 30501
Physical Therapist
597 S ENOTA DR NE
GAINESVILLE, GA 30501

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 Carlos Lucero's NPI number?

The NPI number for Carlos Lucero is 1023421930. It was assigned to this individual provider in the NPPES registry on June 9, 2014.

Where is Carlos Lucero located?

Carlos Lucero practices at 597 S Enota Dr NE, Gainesville, GA 30501. The listed phone number is (770) 219-7777.

What is Carlos Lucero's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Carlos Lucero enrolled in Medicare?

Yes. Carlos Lucero 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 Carlos Lucero accept?

Health plans from Alliant Health Plans, Inc. list Carlos Lucero 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 Carlos Lucero affiliated with any hospitals?

According to CMS data, Carlos Lucero is affiliated with Northeast Georgia Medical Center, Inc.

When was this NPI record last updated?

The NPPES record for Carlos Lucero was last updated on November 1, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.