DR. DAVID W CARTER DO
NPI 1093204083
Family Medicine - Sleep Medicine in Pikeville, KY

Q: What is David Carter's NPI number?

The NPI number for David Carter is 1093204083. It was assigned to this individual provider in the NPPES registry on May 4, 2018.

Q: What is David Carter's specialty?

The primary specialty registered for this NPI is Family Medicine, specializing in Sleep Medicine, with taxonomy code 207QS1201X.

Q: When was this NPI record last updated?

The NPPES record for David Carter was last updated on July 21, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.

Active since May 04, 2018PECOS EnrolledAccepts Medicare Assignment

86.86/100

CMS Quality Rating

911 BYPASS RD BLDG A, PIKEVILLE, KY 41501(606) 430-2209(606) 218-7509 Get Directions Write a Review

NPPES record last updated: July 21, 2022. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jul 21, 2022, May 4, 2018 (2 updates tracked since 2018).

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About Dr. David W Carter Do NPPES

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

DR. DAVID W CARTER DO (NPI 1093204083) is an individual sleep medicine provider in Pikeville, Kentucky, licensed in Kentucky (04796) and active in the NPI registry since May 2018. He is enrolled in Medicare PECOS, is affiliated with Pikeville Medical Center, and is a graduate of Liberty Univ College Of Osteopathic Medicine (2018).

NPPES Registry Identity

NPI1093204083

Entity TypeIndividualMale

Primary Taxonomy207QS1201X

Provider Legal NameDR. DAVID W CARTERCredential: DO

Location Address911 BYPASS RD BLDG APikeville, KY 41501-1689

Mailing AddressPo Box 432Pikeville, KY 41502-0432 · (606) 430-2209 · Fax (606) 218-7509

Phone(606) 430-2209

Fax(606) 218-7509

Sole ProprietorNo

Medical School CMSLiberty Univ College Of Osteopathic MedicineGraduated 2018

Enumeration DateMay 4, 2018

Last NPPES UpdateJuly 21, 20222 updates tracked since enumeration

NPPES CertifiedJuly 21, 2022

✔ NPI 1093204083 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily Medicine · Sleep MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207QS1201X

License✔ Licensed in KY · 04796

Definition

A Family Medicine Physician who practices Sleep Medicine is certified in the subspecialty of sleep medicine and specializes in the clinical assessment, physiologic testing, diagnosis, management and prevention of sleep and circadian rhythm disorders. Sleep specialists treat patients of any age and use multidisciplinary approaches. Disorders managed by sleep specialists include, but are not limited to, sleep related breathing disorders, insomnia, hypersomnias, circadian rhythm sleep disorders, parasomnias and sleep related movement disorders.

911 BYPASS RD BLDG A, Pikeville, KY 41501

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter from Home State Health, Ambetter Health 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

Dr. David W Carter Do 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 ID3072912732

PECOS Enrollment IDI20220817001710

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 7

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.

109 services96 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.

69 services69 patients

Sleep study including heart rate, breathing, airflow, and effort 95806

A sleep study monitors your heart rate, breathing patterns, airflow, and physical effort while you sleep. It helps identify sleep disorders by tracking your sleep stages and cycles. This data aids doctors in diagnosing and treating sleep-related issues.

48 services48 patients

Sleep study in sleep lab (6 years or older) 95810

A sleep study in a sleep lab is a non-invasive overnight test that monitors your body while you sleep. It helps doctors understand your sleep patterns and identify any issues like sleep apnea or insomnia. You'll be connected to equipment that tracks your heart rate, brain waves, breathing, and movements.

31 services31 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.

29 services29 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.

23 services21 patients

Hospital Affiliations CMS Care Compare

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

Pikeville Medical Center

Acute Care Hospitals · Pikeville, KY

1/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number180044

Location911 Bypass RoadPikeville, KY 41501 · Pike County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 41501 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

$82.24 typical visit price

range $52.76 – $162.27

Typical copayment $20.56 (range $13.19 – $40.56)

Most-billed visit code 99203

Established Patient

$93.94 typical visit price

range $16.53 – $131.99

Typical copayment $23.48 (range $4.13 – $32.99)

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.

86.86/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Scored as part of a group practice

Quality

72.39

Promoting Interoperability

100

Improvement Activities

Cost

70.65

Referred Medical Equipment & Supplies CMS DME claims 9

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

Full face mask used with positive airway pressure device, each A7030

DME-Other DME · category DE001N

11 suppliers27 claims27 services$118.59 avg. paid by Medicare

Face mask interface, replacement for full face mask, each A7031

DME-Other DME · category DE001N

10 suppliers26 claims52 services$44.38 avg. paid by Medicare

Headgear used with positive airway pressure device A7035

DME-Other DME · category DE001N

10 suppliers23 claims23 services$23.51 avg. paid by Medicare

Tubing used with positive airway pressure device A7037

DME-Other DME · category DE001N

10 suppliers23 claims23 services$22.09 avg. paid by Medicare

Filter, disposable, used with positive airway pressure device A7038

DME-Other DME · category DE001N

11 suppliers32 claims114 services$3.17 avg. paid by Medicare

Water chamber for humidifier, used with positive airway pressure device, replacement, each A7046

DME-Other DME · category DE001N

5 suppliers13 claims13 services$14.17 avg. paid by Medicare

Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

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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.

MRS. WHITNEY P. BURTON PA-C

Physician Assistant