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MR. RICHARD CARTER MD
NPI 1083660104
Internal Medicine - Hematology & Oncology in Conyers, GA

Active since May 26, 2006PECOS EnrolledAccepts Medicare Assignment
1498 KLONDIKE RD SW, SUITE 106, CONYERS, GA 30094(770) 761-7260(678) 413-1818 Get Directions Write a Review

NPPES record last updated: August 26, 2020. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Mr. Richard Carter Md NPPES

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

MR. RICHARD CARTER MD (NPI 1083660104) is an individual hematology & oncology provider in Conyers, Georgia, licensed in Georgia (038439) and active in the NPI registry since May 2006. He is enrolled in Medicare PECOS, is affiliated with Piedmont Newton Hospital, and is a graduate of Rutgers New Jersey Medical School (1992).

NPPES Registry Identity

NPI1083660104
Entity TypeIndividualMale
Primary Taxonomy207RH0003X
Provider Legal NameMR. RICHARD CARTERCredential: MD
Location Address1498 KLONDIKE RD SW, SUITE 106Conyers, GA 30094-5169
Mailing Address1100 Johnson Ferry Rd Ne, Suite 510Sandy Springs, GA 30342-1709 · (404) 419-1140 · Fax (404) 419-1164
Phone(770) 761-7260
Fax(678) 413-1818
Sole ProprietorNo
Medical School CMSRutgers New Jersey Medical SchoolGraduated 1992
Enumeration DateMay 26, 2006
Last NPPES UpdateAugust 26, 2020
NPPES CertifiedAugust 26, 2020
✔ NPI 1083660104 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · Hematology & OncologyAllopathic & Osteopathic Physicians
Taxonomy Code207RH0003X
License✔ Licensed in GA · 038439
Definition
An internist doctor of osteopathy that specializes in the treatment of the combination of hematology and oncology disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine WAS able to obtain a Certificate of Special Qualifications in the field of Hematology and Oncology. The Certificate is NO longer offered.
1498 KLONDIKE RD SW, Conyers, GA 30094
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Other Identifiers 1

Medicaid00702435CGA

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Absolute Total Care, Ambetter Health, Ambetter of Alabama and more.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

Mr. Richard 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 ID42119224
PECOS Enrollment IDI20100615000477
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 6

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.
618 services204 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.
82 services65 patients
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.
67 services29 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.
22 services22 patients
Initial hospital care with straightforward or low level of medical decision making, per day, if using time, at least 40 minutes 99221
Initial hospital inpatient care refers to the first day of your stay in the hospital. This service typically includes a 30-minute check-up with a healthcare professional. They'll assess your health, discuss your condition, and plan your treatment. It's part of ensuring you receive the best possible care.
21 services18 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.
20 services20 patients

Hospital Affiliations CMS Care Compare 5

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

Piedmont Newton Hospital

Acute Care Hospitals · Covington, GA
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number110018
Location5126 Hospital Drive NECovington, GA 30014 · Newton County
Emergency services Birthing friendly

Northside Hospital Gwinnett

Acute Care Hospitals · Lawrenceville, GA
2/5 CMS rating
OwnershipGovernment - Hospital District or Authority
CMS Certification Number110087
Location1000 Medical Center BoulevardLawrenceville, GA 30046 · Gwinnett County
Birthing friendly

Piedmont Rockdale Hospital

Acute Care Hospitals · Conyers, GA
2/5 CMS rating
OwnershipProprietary
CMS Certification Number110091
Location1412 Milstead Avenue, NEConyers, GA 30012 · Rockdale County
Birthing friendly

Northside Hospital

Acute Care Hospitals · Atlanta, GA
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number110161
Location1000 Johnson Ferry Road, NEAtlanta, GA 30342 · Fulton County
Birthing friendly

Piedmont Henry Hospital

Acute Care Hospitals · Stockbridge, GA
2/5 CMS rating
OwnershipGovernment - Hospital District or Authority
CMS Certification Number110191
Location1133 Eagle's Landing ParkwayStockbridge, GA 30281 · Henry County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 30094 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
$172.43 typical visit price
range $56.84 – $172.43
Typical copayment $43.10 (range $14.21 – $43.10)
Most-billed visit code 99205
Established Patient
$100.20 typical visit price
range $18.22 – $140.40
Typical copayment $25.05 (range $4.55 – $35.10)
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.

Reported Quality Measures

Colorectal Cancer Screening
Percentage of adults 50-75 years of age who had appropriate screening for colorectal cancer
56%557 patients3/55-star benchmark: 85%
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%2,208 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.
81%520 patients4/55-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…
22%45 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%93 patients5/55-star benchmark: 100%
Oncology: Medical and Radiation - Pain Intensity Quantified
Percentage of patient visits, regardless of patient age, with a diagnosis of cancer currently receiving chemotherapy or radiation therapy in which pain intensity is quantified
98%415 patients4/55-star benchmark: 100%
Pain Assessment and Follow-Up
Percentage of visits for patients aged 18 years and older with documentation of a pain assessment using a standardized tool(s) on each visit AND documentation of a follow-up plan when pain is present
78%2,361 patients4/55-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.
39%397 patients2/55-star benchmark: 100%
Preventive Care and Screening: Unhealthy Alcohol Use: Screening & Brief Counseling
Percentage of patients aged 18 years and older who were screened for unhealthy alcohol use using a systematic screening method at least once within the last 24 months AND who received brief counseling if identified as an unhealthy alcohol user
56%846 patients3/55-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…
70%397 patients3/55-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…
29%397 patients2/55-star benchmark: 79%
Use of High-Risk Medications in the Elderly
Percentage of patients 65 years of age and older who were ordered high-risk medications. Two rates are submitted. 1) Percentage of patients who were ordered at least one high-risk medication.
Lower rates are better for this measure.
Patients 2+: 7% · 626 patients
7%626 patients3/55-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.

Other Providers at the Same Location NPPES 6

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

MEGAN JEAN MCKEE M.D.
Internal Medicine (Hematology & Oncology)
1498 KLONDIKE RD SW, SUITE 106
CONYERS, GA 30094
Rockdale County (770) 761-7260
TABITHA WISHARD MCWHORTER PHARMD
Pharmacist (Oncology)
1498 KLONDIKE RD SW, SUITE 106
CONYERS, GA 30094
Rockdale County (770) 761-7260
DR. DONNA-MARIE ERIKA BROWN M.D.
Pediatrics
1498 KLONDIKE RD SW, STE 106
CONYERS, GA 30094
Rockdale County (770) 860-8177
MEG ZERINGUE P.A.
Physician Assistant
1498 KLONDIKE RD SW, SUITE 106
CONYERS, GA 30094
Rockdale County (770) 761-7260
MRS. ROTONDA KEATON WILLIAMS P.A.
Physician Assistant
1498 KLONDIKE RD SW, SUITE 106
CONYERS, GA 30094
Rockdale County (770) 761-7260
NSH CANCER INSTITUTE PROFESSIONAL SERVICES A LLC
Durable Medical Equipment & Medical Supplies
1498 KLONDIKE RD SW, SUITE 106
CONYERS, GA 30094
Rockdale County (770) 761-7260

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 Richard Carter's NPI number?

The NPI number for Richard Carter is 1083660104. It was assigned to this individual provider in the NPPES registry on May 26, 2006.

Where is Richard Carter located?

Richard Carter practices at 1498 Klondike Rd SW Suite 106, Conyers, GA 30094. The listed phone number is (770) 761-7260.

What is Richard Carter's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Hematology & Oncology, with taxonomy code 207RH0003X.

Is Richard Carter enrolled in Medicare?

Yes. Richard 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 Richard Carter accept?

Health plans from Ambetter Health, Ambetter from Absolute Total Care, Ambetter of Alabama, Ambetter of North Carolina and Ambetter of Tennessee list Richard 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 Richard Carter affiliated with any hospitals?

According to CMS data, Richard Carter is affiliated with Piedmont Newton Hospital, Northside Hospital Gwinnett, Piedmont Rockdale Hospital, Northside Hospital and Piedmont Henry Hospital.

When was this NPI record last updated?

The NPPES record for Richard Carter was last updated on August 26, 2020. 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.