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DR. KENNY BERTLYN CARTER JR. M.D.
NPI 1043307804
Otolaryngology in Frisco, TX

Active since October 05, 2006PECOS EnrolledAccepts Medicare Assignment
0/100
CMS Quality Rating
8380 WARREN PKWY, SUITE 504, FRISCO, TX 75034(972) 596-4005(972) 985-1253 Get Directions Write a Review

NPPES record last updated: June 9, 2011. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Dr. Kenny Bertlyn Carter Jr. M.d. NPPES

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

DR. KENNY BERTLYN CARTER JR. M.D. (NPI 1043307804) is an individual otolaryngology provider in Frisco, Texas, licensed in Texas (N9178) and active in the NPI registry since October 2006. He is enrolled in Medicare PECOS, is affiliated with Baylor Scott & White Medical Center - Frisco, and is a graduate of Baylor College Of Medicine (2006).

NPPES Registry Identity

NPI1043307804
Entity TypeIndividualMale
Primary Taxonomy207Y00000X
Provider Legal NameDR. KENNY BERTLYN CARTER JR.Credential: M.D.
Location Address8380 WARREN PKWY, SUITE 504Frisco, TX 75034-4198
Mailing Address8380 Warren Pkwy, Suite 504Frisco, TX 75034-4198 · (972) 596-4005 · Fax (972) 985-1253
Phone(972) 596-4005
Fax(972) 985-1253
Sole ProprietorYes
Medical School CMSBaylor College Of MedicineGraduated 2006
Enumeration DateOctober 5, 2006
Last NPPES UpdateJune 9, 2011
✔ NPI 1043307804 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOtolaryngologyAllopathic & Osteopathic Physicians
Taxonomy Code207Y00000X
License✔ Licensed in TX · N9178
Definition
An otolaryngologist-head and neck surgeon provides comprehensive medical and surgical care for patients with diseases and disorders that affect the ears, nose, throat, the respiratory and upper alimentary systems and related structures of the head and neck. An otolaryngologist diagnoses and provides medical and/or surgical therapy or prevention of diseases, allergies, neoplasms, deformities, disorders and/or injuries of the ears, nose, sinuses, throat, respiratory and upper alimentary systems, face, jaws and the other head and neck systems. Head and neck oncology, facial plastic and reconstructive surgery and the treatment of disorders of hearing and voice are fundamental areas of expertise.
8380 WARREN PKWY, Frisco, TX 75034
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Baylor Scott and White Health Plan, Blue Cross and Blue Shield of Texas, UnitedHealthcare.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. Kenny Bertlyn Carter Jr. 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 ID6305017724
PECOS Enrollment IDI20110926000825
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 13

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 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.
187 services120 patients
Comprehensive hearing and speech recognition test 92557
A comprehensive hearing and speech recognition test assesses your ability to hear and understand spoken words. It includes hearing tests to check for issues with sound perception and speech tests to evaluate your word recognition. It's a crucial step in identifying any hearing or speech problems.
69 services61 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.
59 services47 patients
Diagnostic exam of nasal passages using an endoscope 31231
A diagnostic exam of nasal passages using an endoscope is a non-invasive procedure. A small, flexible tube with a light and camera at the end, called an endoscope, is inserted into the nose. This allows the doctor to view the nasal passages and sinuses, helping to identify any issues.
49 services30 patients
Test for eardrum and muscle function 92550
This test assesses the health of your eardrum and muscles linked to hearing. A small device is placed in your ear that creates pressure changes and sounds. Your ear's responses are recorded to determine if they are functioning properly.
47 services42 patients
Ct scan of face without contrast 70486
A CT scan of the face without contrast is a non-invasive imaging procedure. It uses X-rays to create detailed pictures of your face, including bones, soft tissues, and blood vessels. It's often used to diagnose diseases, injuries, or abnormalities. No contrast dye is used in this procedure.
33 services27 patients

Hospital Affiliations CMS Care Compare 2

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

Baylor Scott & White Medical Center - Frisco

Acute Care Hospitals · Frisco, TX
3/5 CMS rating
OwnershipProprietary
CMS Certification Number450853
Location5601 Warren ParkwayFrisco, TX 75034 · Denton County
Emergency services Birthing friendly

Baylor Scott & White Medical Center Plano

Acute Care Hospitals · Plano, TX
4/5 CMS rating
OwnershipVoluntary non-profit - Other
CMS Certification Number450890
Location4700 Alliance BoulevardPlano, TX 75093 · Collin County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 75034 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
$126.40 typical visit price
range $54.84 – $166.88
Typical copayment $31.60 (range $13.71 – $41.72)
Most-billed visit code 99204
Established Patient
$68.55 typical visit price
range $17.52 – $136.11
Typical copayment $17.13 (range $4.38 – $34.02)
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.

0/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Individually scored
Quality0
Improvement Activities0

Reported Quality Measures

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.
90%1,538 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.
99%877 patients5/55-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.
87%459 patients2/55-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.
5%1,601 patients1/55-star benchmark: 97%
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…
93%1,340 patients4/55-star benchmark: 97%
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: 90% · 492 patients
99%492 patients5/55-star benchmark: 98%
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…
84%1,601 patients4/55-star benchmark: 100%
View, Download, or Transmit (VDT)
At least one patient seen by the MIPS eligible clinician during the performance period (or patient-authorized representative) views, downloads or transmits their health information to a third party during the performance period.
1%1,601 patients
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 2

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

Filter, disposable, used with positive airway pressure device A7038
DME-Other DME · category DE001N
2 suppliers11 claims45 services$1.47 avg. paid by Medicare
Continuous positive airway pressure (cpap) device E0601
DME-Other DME · category DE001N
2 suppliers15 claims15 services$21.19 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.

MS. CHRISTINA MARIE RUSSO PT, DPT
Physical Therapist
8380 WARREN PKWY, SUITE 502
FRISCO, TX 75034
Denton County (214) 618-8055
CHAD RYAN BAILEY MPAS, P.A.-C
Physician Assistant (Medical)
8380 WARREN PKWY, SUITE 504
FRISCO, TX 75034
Denton County (972) 596-4005
ASPIRE RECOVERY CENTER OF FRISCO, LLC
Clinic/Center (Rehabilitation, Substance Use Disorder)
8380 WARREN PKWY, SUITE 602
FRISCO, TX 75034
Denton County (469) 249-9363
BENJAMIN WAGLEY, PLLC
Chiropractor
8380 WARREN PKWY, SUITE 601
FRISCO, TX 75034
Denton County (972) 345-0654
STONEBRIAR SURGERY CENTER, LLC
Clinic/Center (Ambulatory Surgical)
8380 WARREN PKWY, STE 201
FRISCO, TX 75034
Denton County (972) 377-2625
DR. BENJAMIN WAGLEY D.C.
Chiropractor
8380 WARREN PKWY, SUITE 601
FRISCO, TX 75034
Denton County (972) 345-0654
RELEVANCE TOTAL HEALTH LLC
Physician Assistant
8380 WARREN PKWY, BLDG 7 STE 700
FRISCO, TX 75034
Denton County (214) 618-0166
DEREK J LEJEUNE MD PA
Family Medicine
8380 WARREN PKWY, BLD 7 STE 700
FRISCO, TX 75034
Denton County (972) 581-9800

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 Kenny Carter's NPI number?

The NPI number for Kenny Carter is 1043307804. It was assigned to this individual provider in the NPPES registry on October 5, 2006.

Where is Kenny Carter located?

Kenny Carter practices at 8380 Warren Pkwy Suite 504, Frisco, TX 75034. The listed phone number is (972) 596-4005.

What is Kenny Carter's specialty?

The primary specialty registered for this NPI is Otolaryngology with taxonomy code 207Y00000X.

Is Kenny Carter enrolled in Medicare?

Yes. Kenny Carter 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 Kenny Carter accept?

Health plans from Baylor Scott and White Health Plan, Blue Cross and Blue Shield of Texas and UnitedHealthcare list Kenny Carter 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 Kenny Carter affiliated with any hospitals?

According to CMS data, Kenny Carter is affiliated with Baylor Scott & White Medical Center - Frisco and Baylor Scott & White Medical Center Plano.

When was this NPI record last updated?

The NPPES record for Kenny Carter was last updated on June 9, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 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.