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DR. RICHARD ALAN CARLTON M.D.
NPI 1104887850
Thoracic Surgery (Cardiothoracic Vascular Surgery) in Hickory, NC

Active since March 31, 2006PECOS EnrolledAccepts Medicare Assignment
415 N CENTER ST, SUITE 204, HICKORY, NC 28601(828) 323-1100(828) 324-9189 Get Directions Write a Review

NPPES record last updated: February 15, 2017. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Dr. Richard Alan Carlton M.d. NPPES

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

DR. RICHARD ALAN CARLTON M.D. (NPI 1104887850) is an individual thoracic surgery (cardiothoracic vascular surgery) provider in Hickory, North Carolina, licensed in North Carolina (33626) and active in the NPI registry since March 2006. He is enrolled in Medicare PECOS, is affiliated with Frye Regional Medical Center, and is a graduate of University Of Massachusetts Medical School (1981).

NPPES Registry Identity

NPI1104887850
Entity TypeIndividualMale
Primary Taxonomy208G00000X
Provider Legal NameDR. RICHARD ALAN CARLTONCredential: M.D.
Location Address415 N CENTER ST, SUITE 204Hickory, NC 28601-5057
Mailing Address415 N Center St, Suite 204Hickory, NC 28601-5057 · (828) 323-1100 · Fax (828) 324-9189
Phone(828) 323-1100
Fax(828) 324-9189
Sole ProprietorNo
Medical School CMSUniversity Of Massachusetts Medical SchoolGraduated 1981
Enumeration DateMarch 31, 2006
Last NPPES UpdateFebruary 15, 2017
✔ NPI 1104887850 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyThoracic Surgery (Cardiothoracic Vascular Surgery)Allopathic & Osteopathic Physicians
Taxonomy Code208G00000X
License✔ Licensed in NC · 33626
Definition
A thoracic surgeon provides the operative, perioperative and critical care of patients with pathologic conditions within the chest. Included is the surgical care of coronary artery disease, cancers of the lung, esophagus and chest wall, abnormalities of the trachea, abnormalities of the great vessels and heart valves, congenital anomalies, tumors of the mediastinum and diseases of the diaphragm. The management of the airway and injuries of the chest is within the scope of the specialty.
415 N CENTER ST, Hickory, NC 28601
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Other Identifiers 4

Other3760384NC · Carolina Care Plan (php)
Medicaid8921144NC
Medicare UPINE07605NC
Medicare ID-Type Unspecified213866BNC

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of NC, 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. Richard Alan Carlton 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 ID6305818568
PECOS Enrollment IDI20100331000780
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 4

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 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.
30 services16 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.
17 services17 patients
Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes 99222
Initial hospital inpatient care is a service where a healthcare provider spends about 50 minutes per day overseeing your care while you're admitted in the hospital. This includes reviewing your health status, planning your treatment, and ensuring your safety and comfort.
15 services15 patients
Harvest of vein using an endoscope 33508
Harvesting a vein using an endoscope is a procedure where a small camera is used to help surgeons remove a vein from your body. This vein is often used to bypass a blocked artery, improving blood flow to your heart.
12 services12 patients

Hospital Affiliations CMS Care Compare

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

Frye Regional Medical Center

Acute Care Hospitals · Hickory, NC
1/5 CMS rating
OwnershipProprietary
CMS Certification Number340116
Location420 N Center StHickory, NC 28601 · Catawba County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 28601 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
$165.09 typical visit price
range $54.12 – $165.09
Typical copayment $41.27 (range $13.53 – $41.27)
Most-billed visit code 99205
Established Patient
$67.72 typical visit price
range $17.21 – $134.61
Typical copayment $16.93 (range $4.30 – $33.65)
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.

Reported Quality Measures

Breast Cancer Screening
Percentage of women 50-74 years of age who had a mammogram to screen for breast cancer
4%27 patients1/55-star benchmark: 92%
Closing the Referral Loop: Receipt of Specialist Report
Percentage of patients with referrals, regardless of age, for which the referring provider receives a report from the provider to whom the patient was referred
6%32 patients1/55-star benchmark: 95%
Colorectal Cancer Screening
Percentage of adults 50-75 years of age who had appropriate screening for colorectal cancer
7%69 patients1/55-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.
100%354 patients5/55-star benchmark: 100%
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%60 patients5/55-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.
52%251 patients3/55-star benchmark: 97%
Pneumococcal Vaccination Status for Older Adults
Percentage of patients 65 years of age and older who have ever received a pneumococcal vaccine
8%79 patients1/55-star benchmark: 90%
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…
17%103 patients1/55-star benchmark: 97%
Preventive Care and Screening: Screening for Depression and Follow-Up Plan
Percentage of patients aged 12 years and older screened for depression on the date of the encounter using an age appropriate standardized depression screening tool AND if positive, a follow-up plan is documented on the date of the positive screen
2%111 patients1/55-star benchmark: 96%
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…
78%251 patients4/55-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…
6%251 patients1/55-star benchmark: 89%
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.
23%251 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.

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.

DR. GAA ODETTA RICHARDSON M.D.
Internal Medicine (Gastroenterology)
415 N CENTER ST, SUITE 300
HICKORY, NC 28601
Catawba County (828) 328-3300
BAKER HENSON DO
Surgery
415 N CENTER ST, SUITE 102
HICKORY, NC 28601
Catawba County (828) 327-9178
MR. DONALD E LOWE CRNA
Nurse Anesthetist, Certified Registered
415 N CENTER ST, STE 201
HICKORY, NC 28601
Catawba County (828) 327-8105
DR. DONALD HUGH BROWN II MD
Anesthesiology
415 N CENTER ST, SUITE 201
HICKORY, NC 28601
Catawba County (828) 327-8105
ALLEN ORLIN SMITH M.D.
Psychiatry & Neurology (Neurology)
415 N CENTER ST, SUITE 202
HICKORY, NC 28601
Catawba County (828) 327-9869
KATHERINE D DELLINGER CRNA
Nurse Anesthetist, Certified Registered
415 N CENTER ST, SUITE 201
HICKORY, NC 28601
Catawba County (828) 327-8105
DR. JOHN HARVEY MEIER M.D.
Internal Medicine (Gastroenterology)
415 N CENTER ST, SUITE 300
HICKORY, NC 28601
Catawba County (828) 328-3300
ROBERT A HARTMAN CRNA
Nurse Anesthetist, Certified Registered
415 N CENTER ST, STE 201
HICKORY, NC 28601
Catawba County (828) 327-8105

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 Carlton's NPI number?

The NPI number for Richard Carlton is 1104887850. It was assigned to this individual provider in the NPPES registry on March 31, 2006.

Where is Richard Carlton located?

Richard Carlton practices at 415 N Center St Suite 204, Hickory, NC 28601. The listed phone number is (828) 323-1100.

What is Richard Carlton's specialty?

The primary specialty registered for this NPI is Thoracic Surgery (Cardiothoracic Vascular Surgery) with taxonomy code 208G00000X.

Is Richard Carlton enrolled in Medicare?

Yes. Richard Carlton 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 Carlton accept?

Health plans from Blue Cross and Blue Shield of NC and UnitedHealthcare list Richard Carlton 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 Carlton affiliated with any hospitals?

According to CMS data, Richard Carlton is affiliated with Frye Regional Medical Center.

When was this NPI record last updated?

The NPPES record for Richard Carlton was last updated on February 15, 2017. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 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.