FRANK MOULTON CARTER MD
NPI 1063405165
Colon & Rectal Surgery in West Reading, PA

Active since August 24, 2005PECOS EnrolledAccepts Medicare Assignment
94.52/100
CMS Quality Rating
301 S 7TH AVE, SUITE 100, WEST READING, PA 19611(610) 375-6001(610) 374-0678 Get Directions Write a Review

NPPES record last updated: May 21, 2008. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Frank Moulton Carter Md NPPES

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

FRANK MOULTON CARTER MD (NPI 1063405165) is an individual colon & rectal surgery provider in West Reading, Pennsylvania, licensed in Pennsylvania (MD041054E) and active in the NPI registry since August 2005. He is enrolled in Medicare PECOS, is affiliated with Reading Hospital, and is a graduate of Temple University School Of Medicine (1984).

NPPES Registry Identity

NPI1063405165
Entity TypeIndividualMale
Primary Taxonomy208C00000X
Provider Legal NameFRANK MOULTON CARTERCredential: MD
Location Address301 S 7TH AVE, SUITE 100West Reading, PA 19611-1410
Mailing Address301 S 7th Ave, Suite 100West Reading, PA 19611-1410 · (610) 375-6001 · Fax (610) 374-0678
Fax(610) 374-0678
Sole ProprietorNo
Medical School CMSTemple University School Of MedicineGraduated 1984
Enumeration DateAugust 24, 2005
Last NPPES UpdateMay 21, 2008
NPI 1063405165 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyColon & Rectal SurgeryAllopathic & Osteopathic Physicians
Taxonomy Code208C00000X
Licenses Licensed in PA · MD041054E Licensed in PA · BC2250467
Definition

A colon and rectal surgeon is trained to diagnose and treat various diseases of the intestinal tract, colon, rectum, anal canal and perianal area by medical and surgical means. This specialist also deals with other organs and tissues (such as the liver, urinary and female reproductive system) involved with primary intestinal disease.

301 S 7TH AVE, West Reading, PA 19611

Other Identifiers 2

Medicare UPINE67529PA
Medicare PIN716597PA

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

Frank Moulton Carter 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 ID3274583539
PECOS Enrollment IDI20110113000729
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.

Subsequent hospital care with straightforward or low level of medical decision making, per day, if using time, at least 25 minutes 99231
Follow-up hospital inpatient care is a daily service where a healthcare professional checks on your health progress during your hospital stay. Each session typically lasts 15 minutes, involving updates on your condition and adjustments to your treatment plan, if necessary.
70 services27 patients
Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes 99223
Initial hospital inpatient care per day, typically 70 minutes, refers to the daily medical service provided to patients admitted to the hospital. This includes a comprehensive evaluation, diagnosis, treatment plan, and monitoring of your health condition. It ensures your well-being during your hospital stay.
50 services41 patients
Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes 99233
Follow-up hospital inpatient care per day typically involves a 35-minute check-up by your healthcare provider. This service includes monitoring your health progress, adjusting your treatment plan if needed, and answering any questions you may have about your condition or care.
47 services12 patients
New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203
This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.
46 services46 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.
36 services31 patients
Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes 99232
Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.
33 services15 patients

Hospital Affiliations CMS Care Compare

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

Reading Hospital

Acute Care Hospitals · West Reading, PA
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number390044
Location420 S 5th AvenueWest Reading, PA 19611 · Berks County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 19611 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
$84.88 typical visit price
range $54.64 – $166.87
Typical copayment $21.22 (range $13.66 – $41.71)
Most-billed visit code 99203
Established Patient
$68.36 typical visit price
range $17.33 – $135.84
Typical copayment $17.09 (range $4.33 – $33.96)
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.

94.52/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality96.97
Promoting Interoperability96
Improvement Activities40
Cost84.38

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…
23%159 patients1/55-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.

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.

Skin barrier; solid, 4 x 4 or equivalent; each A4362
DME-Orthotic Devices · category DF010N
2 suppliers20 claims400 services$3.36 avg. paid by Medicare
Ostomy skin barrier, solid 4 x 4 or equivalent, extended wear, without built-in convexity, each A4385
DME-Orthotic Devices · category DF010N
4 suppliers24 claims500 services$4.92 avg. paid by Medicare
Ostomy pouch, drainable, with barrier attached, with built-in convexity (1 piece), each A4389
DME-Orthotic Devices · category DF010N
1 supplier13 claims260 services$5.63 avg. paid by Medicare
Ostomy pouch, drainable; for use on barrier with flange (2 piece system), each A5063
DME-Orthotic Devices · category DF010N
4 suppliers13 claims470 services$2.61 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.

Internal Medicine (Interventional Cardiology)
301 S 7TH AVE, SUITE 2020
WEST READING, PA 19611
Specialist
301 S 7TH AVE, STE 135
WEST READING, PA 19611
Physical Therapist
301 S 7TH AVE, STE 3220
WEST READING, PA 19611
Psychiatry & Neurology (Neurology)
301 S 7TH AVE, SUITE 210
READING, PA 19611
Specialist
301 S 7TH AVE, STE 135
WEST READING, PA 19611
Orthopaedic Surgery
301 S 7TH AVE, SUITE 3220
WEST READING, PA 19611
Physical Therapist
301 S 7TH AVE, SUITE 3020
WEST READING, PA 19611
Internal Medicine (Interventional Cardiology)
301 S 7TH AVE, SUITE 2020
WEST READING, PA 19611

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 Frank Carter's NPI number?

The NPI number for Frank Carter is 1063405165. It was assigned to this individual provider in the NPPES registry on August 24, 2005.

Where is Frank Carter located?

Frank Carter practices at 301 S 7th Ave Suite 100, West Reading, PA 19611. The listed phone number is (610) 375-6001.

What is Frank Carter's specialty?

The primary specialty registered for this NPI is Colon & Rectal Surgery with taxonomy code 208C00000X.

Is Frank Carter enrolled in Medicare?

Yes. Frank 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.

Is Frank Carter affiliated with any hospitals?

According to CMS data, Frank Carter is affiliated with Reading Hospital.

When was this NPI record last updated?

The NPPES record for Frank Carter was last updated on May 21, 2008. NPI Profile syncs with the weekly NPPES data releases published by CMS.