CARL W BAKER MD
NPI 1154398253
Ophthalmology - Retina Specialist in Hilton Head Island, SC

Q: What is Carl Baker's NPI number?

The NPI number for Carl Baker is 1154398253. It was assigned to this individual provider in the NPPES registry on March 7, 2006.

Q: What is Carl Baker's specialty?

The primary specialty registered for this NPI is Ophthalmology, specializing in Retina Specialist, with taxonomy code 207WX0107X.

Q: When was this NPI record last updated?

The NPPES record for Carl Baker was last updated on March 17, 2021. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since March 07, 2006PECOS EnrolledAccepts Medicare Assignment

100/100

CMS Quality Rating

15 LAFAYETTE PL STE C, HILTON HEAD ISLAND, SC 29926(843) 715-2424(843) 715-2945 Get Directions Write a Review

NPPES record last updated: March 17, 2021. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Mar 17, 2021, Nov 14, 2018 (2 updates tracked since 2018).

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About Carl W Baker Md NPPES

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

CARL W BAKER MD (NPI 1154398253) is an individual retina specialist in Hilton Head Island, South Carolina, licensed in South Carolina (17421) and active in the NPI registry since March 2006. He is enrolled in Medicare PECOS, maintains a secondary practice location in Paducah, and is a graduate of University Of Kentucky College Of Medicine (1993).

NPPES Registry Identity

NPI1154398253

Entity TypeIndividualMale

Primary Taxonomy207WX0107X

Provider Legal NameCARL W BAKERCredential: MD

Location Address15 LAFAYETTE PL STE CHilton Head Island, SC 29926-2277

Mailing Address15 Lafayette Pl Ste CHilton Head Island, SC 29926-2277 · (843) 715-2424 · Fax (843) 715-2945

Phone(843) 715-2424

Fax(843) 715-2945

Sole ProprietorNo

Medical School CMSUniversity Of Kentucky College Of MedicineGraduated 1993

Enumeration DateMarch 7, 2006

Last NPPES UpdateMarch 17, 20212 updates tracked since enumeration

NPPES CertifiedMarch 17, 2021

✔ NPI 1154398253 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyOphthalmology · Retina SpecialistAllopathic & Osteopathic Physicians

Taxonomy Code207WX0107X

Licenses✔ Licensed in SC · 17421✔ Licensed in KY · 32965

Definition

An ophthalmologist who specializes in the diagnosis and treatment of vitreoretinal diseases.

Also ListedOphthalmologyTaxonomy 207W00000X · License 32965 (KY), 17421 (SC)

15 LAFAYETTE PL STE C, Hilton Head Island, SC 29926

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Secondary Practice Location 1

Location 14630 Village Square DrPaducah, KY 42001-7502 · Phone (270) 442-1671 · Fax (270) 442-7307

Other Identifiers 5

Other180029586Railroad Medicare

Medicaid64329659KY

Other610706763Tricare

Medicaid7100053130KY

Other000000044963Anthem Bcbs

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma, Blue Cross and Blue Shield of Texas 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

Carl W Baker 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 ID2769514116

PECOS Enrollment IDI20100720000814, I20190923001862

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 25

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.

Injection, faricimab-svoa, 0.1 mg J2777

Faricimab-svoa is a medication given through an injection into the eye to treat certain eye conditions. The 0.1 mg dosage helps control disease progression, improving vision and eye health. The procedure is done by a healthcare professional.

42,660 services146 patients

Imaging of retina 92134

Imaging of the retina is a non-invasive procedure that captures detailed images of your eye's interior. This helps detect conditions like macular degeneration or retinal detachment. It's painless and takes only a few minutes.

2,998 services932 patients

Injection of drug into eye 67028

An injection into the eye is a procedure where a medication is delivered directly into your eye to treat various conditions. A local anesthetic is applied to numb the eye, ensuring minimal discomfort. The drug helps manage diseases like macular degeneration or diabetic retinopathy.

1,667 services370 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.

1,635 services789 patients

Injection, aflibercept, 1 mg J0178

Aflibercept injection is a treatment for certain eye conditions that affect vision. It works by blocking abnormal blood vessel growth and leakage in the eye, which can cause vision loss. The medication is administered directly into the eye by a healthcare professional.

1,022 services107 patients

Photography of the retina 92250

Photography of the retina, also known as retinal imaging, is a non-invasive procedure that captures images of the back of your eye. This helps doctors identify and monitor conditions like glaucoma, macular degeneration, or diabetic retinopathy. It's painless and quick, often part of a routine eye exam.

477 services307 patients

Injection, bevacizumab, 10 mg J9035

Bevacizumab is a medication given through an injection. It's designed to prevent the growth of new blood vessels that cancer cells need to grow and spread. The 10 mg dose refers to the amount of the drug in the injection.

331 services94 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.

227 services227 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.

199 services199 patients

Injection, dexamethasone, intravitreal implant, 0.1 mg J7312

This procedure involves placing a tiny implant into your eye. This implant slowly releases a medication called dexamethasone, which helps to reduce inflammation and swelling in the eye, improving vision and comfort.

182 services12 patients

Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more 99212

This is a routine check-up for patients who have previously seen the doctor. During this 10-19 minute visit, the doctor will review your health status, discuss any concerns, and manage ongoing treatments or medications. It's a chance to ensure your health is on track.

158 services147 patients

Injection, triamcinolone acetonide, not otherwise specified, 10 mg J3301

Triamcinolone acetonide is a medication used to reduce inflammation in the body. It's given as a 10 mg injection for conditions like allergies, arthritis, or skin problems. The injection helps to decrease swelling, redness, and itching.

107 services18 patients

Exam of retinal blood vessels using a special camera after injection of a dye 92235

This procedure, known as a fluorescein angiography, involves taking images of the back of your eye. A dye is injected into your arm that travels to your eye, highlighting the blood vessels in your retina. This helps identify any abnormalities.

105 services104 patients

Removal of eye fluid (vitreous) between lens and retina 67036

This procedure, known as a vitrectomy, involves removing some or all of the vitreous humor, the clear gel-like substance in the eye. It's done to treat various eye conditions, like retinal detachment or macular hole. The aim is to improve or stabilize vision. It's performed under local or general anesthesia.

46 services38 patients

Unclassified biologics J3590

Unclassified biologics are a type of treatment derived from living organisms. They can include a wide range of substances, such as vaccines, blood components, or genes, used to prevent or treat diseases. Each is specifically designed to interact with the body's natural defenses to promote healing.

45 services15 patients

Measurement of corneal curvature and depth of eye 92136

This procedure measures the shape and depth of your eye, specifically the cornea, the clear front surface. It helps in diagnosing conditions, planning for surgeries, or fitting contact lenses. It's non-invasive and painless.

41 services22 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.

38 services36 patients

Imaging of optic nerve 92133

Imaging of the optic nerve is a non-invasive procedure that captures detailed pictures of your optic nerve. It helps doctors assess eye health, particularly for conditions like glaucoma. It's painless, quick, and uses safe technology like MRI or OCT (Optical Coherence Tomography).

34 services20 patients

2d ultrasound scan of eye tissue and structures 76512

A 2D ultrasound scan of eye tissue and structures is a non-invasive procedure that uses sound waves to create images of your eye. It helps doctors to examine your eye's internal structures, detect abnormalities, and plan for treatments if needed.

33 services25 patients

Removal of membrane of retina 67041

Removal of the retina's membrane is a surgical procedure aimed at treating eye conditions affecting the retina's function. It involves a delicate operation to eliminate scar tissue or membranes causing vision problems. The procedure can help improve or stabilize vision.

29 services28 patients

Removal of cataract with insertion of prosthetic lens 66984

This is a procedure where a cloudy lens in your eye, known as a cataract, is removed. After removal, a clear artificial lens is inserted. This helps to restore your vision, enabling you to see clearly again.

21 services18 patients

Removal of recurring cataract in lens capsule using a laser 66821

This procedure, known as YAG laser capsulotomy, treats cloudiness in the lens capsule following cataract surgery. A laser is used to create a small hole in the cloudy capsule, allowing light to pass through and restore clear vision. It's a quick, painless procedure.

16 services14 patients

Repair of detached retina with drainage and removal of eye fluid between lens and retina 67108

This procedure addresses a detached retina, a serious eye condition. It involves draining fluid from between the lens and retina, allowing the retina to reattach. Then, the eye fluid is removed to prevent future detachments. It's a crucial step for vision restoration.

13 services13 patients

Heat or freezing treatment to prevent detachment of retina 67141

Heat or freezing treatment, also known as laser photocoagulation or cryopexy, is a procedure to secure the retina to the eye's wall. It involves applying a controlled amount of heat or cold to create scar tissue, which helps prevent retinal detachment and preserve vision.

12 services12 patients

Exam of visual field with extended testing 92083

An extended visual field exam is a detailed test to evaluate your peripheral (side) vision. It helps to detect any potential blind spots which may not be noticeable in daily life. These could be caused by eye diseases like glaucoma, or neurological conditions.

12 services11 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 29926 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

$124.04 typical visit price

range $53.57 – $163.84

Typical copayment $31.01 (range $13.39 – $40.96)

Most-billed visit code 99204

Established Patient

$67.12 typical visit price

range $16.96 – $133.52

Typical copayment $16.78 (range $4.24 – $33.38)

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.

100/100

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

Individually scored

Quality

100

Improvement Activities

Reported Quality Measures

Adult Primary Rhegmatogenous Retinal Detachment Surgery: Visual Acuity Improvement Within 90 Days of Surgery

83%30 patients4/55-star benchmark: 99%

Age-Related Macular Degeneration (AMD): Dilated Macular Examination

97%480 patients4/55-star benchmark: 100%

Closing the Referral Loop: Receipt of Specialist Report

92%48 patients5/55-star benchmark: 87%

Diabetes: Eye Exam

100%142 patients5/55-star benchmark: 100%

Diabetic Macular Edema - Loss of Visual Acuity

100%31 patients

Diabetic Retinopathy: Communication with the Physician Managing Ongoing Diabetes Care

93%150 patients4/55-star benchmark: 100%

Documentation of Current Medications in the Medical Record

100%3,227 patients5/55-star benchmark: 100%

Falls: Screening for Future Fall Risk

99%1,269 patients4/55-star benchmark: 100%

Glaucoma Intraocular Pressure Reduction

93%58 patients

Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention

Patients combinedPopulations: 99% · 954 patients

Patients screened: 100% · 954 patients

88%42 patients4/55-star benchmark: 100%

Primary Open-Angle Glaucoma (POAG): Reduction of Intraocular Pressure (IOP) by 15% OR Documentation of a Plan of Care

100%88 patients

Use of High-Risk Medications in Older Adults

Lower rates are better for this measure.

Patients appropriateDiagnosis: 0% · 1,304 patients

Patients totalRate: 0% · 1,304 patients

0%1,304 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.

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Other Providers at the Same Location NPPES

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

HILTON HEAD RETINA INSTITUTE, LLC

Ophthalmology (Retina Specialist)

15 LAFAYETTE PL STE C
HILTON HEAD ISLAND, SC 29926

Beaufort County (270) 556-3080

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 Carl Baker's NPI number?

The NPI number for Carl Baker is 1154398253. It was assigned to this individual provider in the NPPES registry on March 7, 2006.

Where is Carl Baker located?

Carl Baker practices at 15 Lafayette Pl Ste C, Hilton Head Island, SC 29926. The listed phone number is (843) 715-2424.

What is Carl Baker's specialty?

The primary specialty registered for this NPI is Ophthalmology, specializing in Retina Specialist, with taxonomy code 207WX0107X.

Is Carl Baker enrolled in Medicare?

Yes. Carl Baker 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 Carl Baker accept?

Health plans from Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma, Blue Cross and Blue Shield of Texas, BlueCross BlueShield of South Carolina and UnitedHealthcare list Carl Baker 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.

When was this NPI record last updated?

The NPPES record for Carl Baker was last updated on March 17, 2021. NPI Profile syncs with the weekly NPPES data releases published by CMS.