ANTHONY CRAIG CARTER MD
NPI 1104890276
Internal Medicine in Tompkinsville, KY

Q: What is Anthony Carter's NPI number?

The NPI number for Anthony Carter is 1104890276. It was assigned to this individual provider in the NPPES registry on February 15, 2006.

Q: What is Anthony Carter's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Q: When was this NPI record last updated?

The NPPES record for Anthony Carter was last updated on July 26, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 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 February 15, 2006PECOS EnrolledAccepts Medicare Assignment

45.03/100

CMS Quality Rating

604 N MAIN ST, TOMPKINSVILLE, KY 42167(270) 407-5150(270) 407-5153 Get Directions Write a Review

NPPES record last updated: July 26, 2016. Verified against the NPPES registry weekly; last sync: October 25, 2026.

On this page

About Anthony Craig Carter Md NPPES

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

ANTHONY CRAIG CARTER MD (NPI 1104890276) is an individual internal medicine provider in Tompkinsville, Kentucky, licensed in Kentucky (23371) and active in the NPI registry since February 2006. He is enrolled in Medicare PECOS, is affiliated with The Medical Center (bowling Green), and is a graduate of University Of Louisville School Of Medicine (1983).

NPPES Registry Identity

NPI1104890276

Entity TypeIndividualMale

Primary Taxonomy207R00000X

Provider Legal NameANTHONY CRAIG CARTERCredential: MD

Location Address604 N MAIN STTompkinsville, KY 42167-1128

Mailing Address604 N Main StTompkinsville, KY 42167-1128 · (270) 407-5150 · Fax (270) 407-5153

Phone(270) 407-5150

Fax(270) 407-5153

Sole ProprietorNo

Medical School CMSUniversity Of Louisville School Of MedicineGraduated 1983

Enumeration DateFebruary 15, 2006

Last NPPES UpdateJuly 26, 2016

✔ NPI 1104890276 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207R00000X

Licenses✔ Licensed in KY · 23371✔ Licensed in TN · 0000035137

Definition

A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.

604 N MAIN ST, Tompkinsville, KY 42167

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Other Identifiers 5

Medicaid64233711KY

Medicare PIN1440501KY

Other000000815201KS · Anthem

Medicaid4181459TN

Medicare PINK058121KY

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter Health, Ambetter of Tennessee and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Anthony Craig 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 ID3577644368

PECOS Enrollment IDI20130520000339

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.

Medicare Billing Reassignments

Medicare enrollment records show Anthony Carter reassigns Medicare billing to 5 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Monroe Medical Foundation, Inc.

0.2 mi

Family Medicine

604 N MAIN ST
Tompkinsville, KY 42167

Reassigned Medicare billing, Kentucky enrollment
42 clinicians in this Medicare group

NPI 1083854434 (270) 487-9231

Cumberland County Hospital Association Inc

19 mi

Critical Access

299 GLASGOW RD
Burkesville, KY 42717

Reassigned Medicare billing, Kentucky enrollment
66 clinicians in this Medicare group

NPI 1073567608 (270) 864-2511

Jane Todd Crawford Memorial Hospital Inc.

41 mi

Critical Access

290 INDUSTRIAL PARK RD.
Greensburg, KY 42743

Reassigned Medicare billing, Kentucky enrollment
14 clinicians in this Medicare group

NPI 1225161524 (270) 932-4211

Wayne County Hospital, Inc

47 mi

Family Medicine

166 HOSPITAL ST
Monticello, KY 42633

Reassigned Medicare billing, Kentucky enrollment
26 clinicians in this Medicare group

NPI 1841501947 (606) 348-9343

Casey County Hospital District

60 mi

Critical Access

187 WOLFORD AVE
Liberty, KY 42539

Reassigned Medicare billing, Kentucky enrollment
29 clinicians in this Medicare group

NPI 1407829567 (606) 787-6275

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims 10

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.

248 services77 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.

142 services81 patients

Hospital discharge day management, 30 minutes or less 99238

Hospital discharge day management of 30 minutes or less includes finalizing your treatment, discussing your progress, and planning after-care at home. It ensures you're ready to leave the hospital and continue recovery safely.

114 services66 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.

100 services46 patients

Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes 99309

A follow-up nursing facility visit per day is a daily check-in by a healthcare professional. This 25-minute visit typically involves monitoring your health progress, addressing any concerns, and adjusting treatment plans as necessary. It's a vital part of ensuring your ongoing wellbeing.

69 services26 patients

Exercise or drug-induced heart stress test with electrocardiogram (ecg) with supervision by physician 93016

An exercise or drug-induced heart stress test with ECG involves monitoring your heart's activity while it's under stress, either from exercise or medication. A doctor supervises the entire procedure to ensure safety and accuracy in results. This test helps detect heart problems.

66 services64 patients

Hospital Affiliations CMS Care Compare 3

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

The Medical Center (bowling Green)

Acute Care Hospitals · Bowling Green, KY

2/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number180013

Location250 Park StreetBowling Green, KY 42101 · Warren County

Emergency services Birthing friendly

T J Samson Community Hospital

Acute Care Hospitals · Glasgow, KY

3/5 CMS rating

OwnershipVoluntary non-profit - Other

CMS Certification Number180017

Location1301 North Race StreetGlasgow, KY 42141 · Barren County

Emergency services Birthing friendly

Monroe County Medical Center

Acute Care Hospitals · Tompkinsville, KY

1/5 CMS rating

OwnershipVoluntary non-profit - Other

CMS Certification Number180105

Location529 Capp Harlan RoadTompkinsville, KY 42167 · Monroe County

Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 42167 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

$122.77 typical visit price

range $52.76 – $162.27

Typical copayment $30.69 (range $13.19 – $40.56)

Most-billed visit code 99204

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.

45.03/100

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

Scored as part of a group practice

Quality

30.6

Improvement Activities

Cost

27.35

Reported Quality Measures

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.

100%8,265 patients5/55-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 23

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

Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253

DME-Other DME · category DE017N

4 suppliers108 claims201 services$5.42 avg. paid by Medicare

Lancets, per box of 100 A4259

DME-Medical/Surgical Supplies · category DA000N

4 suppliers45 claims45 services$0.85 avg. paid by Medicare

Ostomy pouch, drainable, with barrier attached, with filter (1 piece), each A4424

DME-Orthotic Devices · category DF010N

1 supplier12 claims240 services$3.06 avg. paid by Medicare

For diabetics only, fitting (including follow-up), custom preparation and supply of off-the-shelf depth-inlay shoe manufactured to accommodate multi-density insert(s), per shoe A5500

DME-Orthotic Devices · category DF000N

4 suppliers15 claims30 services$61.14 avg. paid by Medicare

For diabetics only, multiple density insert, direct formed, molded to foot after external heat source of 230 degrees fahrenheit or higher, total contact with patient's foot, including arch, base layer minimum of 1/4 inch material of shore a 35 durometer or 3/16 inch material of shore a 40 durometer (or higher), prefabricated, each A5512

DME-Orthotic Devices · category DF000N

3 suppliers14 claims84 services$24.91 avg. paid by Medicare

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

DME-Other DME · category DE001N

3 suppliers16 claims20 services$38.61 avg. paid by Medicare

Cushion for use on nasal mask interface, replacement only, each A7032

DME-Other DME · category DE001N

3 suppliers11 claims44 services$23.08 avg. paid by Medicare

Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap A7034

DME-Other DME · category DE001N

4 suppliers13 claims13 services$68.85 avg. paid by Medicare

Headgear used with positive airway pressure device A7035

DME-Other DME · category DE001N

5 suppliers12 claims12 services$23.58 avg. paid by Medicare

Tubing used with positive airway pressure device A7037

DME-Other DME · category DE001N

4 suppliers18 claims18 services$22.24 avg. paid by Medicare

Filter, disposable, used with positive airway pressure device A7038

DME-Other DME · category DE001N

5 suppliers33 claims100 services$3.02 avg. paid by Medicare

Enteral formula, nutritionally complete, calorically dense (equal to or greater than 1.5 kcal/ml) with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit B4152

Other-Enteral and Parenteral · category OB006N

1 supplier11 claims5,822 services$0.40 avg. paid by Medicare

Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress E0260

DME-Hospital Beds · category DB000N

3 suppliers26 claims26 services$61.27 avg. paid by Medicare

Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing E0431

DME-Oxygen and Supplies · category DC000N

4 suppliers27 claims29 services$20.57 avg. paid by Medicare

Humidifier, heated, used with positive airway pressure device E0562

DME-Other DME · category DE001N

1 supplier17 claims17 services$16.38 avg. paid by Medicare

Nebulizer, with compressor E0570

DME-Other DME · category DE000N

6 suppliers82 claims82 services$8.46 avg. paid by Medicare

Continuous positive airway pressure (cpap) device E0601

DME-Other DME · category DE001N

2 suppliers25 claims25 services$50.72 avg. paid by Medicare

Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate E1390

DME-Oxygen and Supplies · category DC002N

10 suppliers132 claims138 services$111.73 avg. paid by Medicare

Portable oxygen concentrator, rental E1392

DME-Oxygen and Supplies · category DC002N

3 suppliers84 claims88 services$36.76 avg. paid by Medicare

Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 1 mg J7613

DME-Drugs Administered Through DME · category DG006N

7 suppliers36 claims6,216 services$0.03 avg. paid by Medicare

Standard wheelchair K0001

DME-Wheelchairs · category DD000N

3 suppliers35 claims37 services$27.13 avg. paid by Medicare

Supply allowance for therapeutic continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service K0553

DME-Other DME · category DE017N

3 suppliers27 claims28 services$178.10 avg. paid by Medicare

Pharmacy dispensing fee for inhalation drug(s); per 30 days Q0513

DME-Other DME · category DE000N

8 suppliers39 claims39 services$21.27 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 2

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

MONROE MEDICAL FOUNDATION, INC.

Family Medicine

604 N MAIN ST
TOMPKINSVILLE, KY 42167

Monroe County (270) 487-9231

MONROE MEDICAL FOUNDATION INC

Clinic/Center (Rural Health)

604 N MAIN ST
TOMPKINSVILLE, KY 42167

Monroe County (270) 407-5150

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 Anthony Carter's NPI number?

The NPI number for Anthony Carter is 1104890276. It was assigned to this individual provider in the NPPES registry on February 15, 2006.

Where is Anthony Carter located?

Anthony Carter practices at 604 N Main St, Tompkinsville, KY 42167. The listed phone number is (270) 407-5150.

What is Anthony Carter's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Is Anthony Carter enrolled in Medicare?

Yes. Anthony 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.

Which organizations bill Medicare for Anthony Carter's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Anthony Carter reassigns Medicare benefits to 5 organizations: Monroe Medical Foundation, Inc. (Tompkinsville, KY), Cumberland County Hospital Association Inc (Burkesville, KY), Jane Todd Crawford Memorial Hospital Inc. (Greensburg, KY), Wayne County Hospital, Inc (Monticello, KY) and Casey County Hospital District (Liberty, KY). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Anthony Carter's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Anthony Carter accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter of Tennessee and Anthem Blue Cross and Blue Shield list Anthony 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 Anthony Carter affiliated with any hospitals?

According to CMS data, Anthony Carter is affiliated with The Medical Center (bowling Green), T J Samson Community Hospital and Monroe County Medical Center.

When was this NPI record last updated?

The NPPES record for Anthony Carter was last updated on July 26, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 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.