DR. JAMES F CARSTEN MD
NPI 1194756023
Family Medicine in Ooltewah, TN

Active since July 06, 2006PECOS EnrolledAccepts Medicare Assignment
94.1/100
CMS Quality Rating
9309 APISON PIKE, OOLTEWAH, TN 37363(423) 551-3562(423) 551-3563 Get Directions Write a Review

NPPES record last updated: September 25, 2023. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Mar 20, 2023, Dec 18, 2019 (2 updates tracked since 2019).

About Dr. James F Carsten Md NPPES

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

DR. JAMES F CARSTEN MD (NPI 1194756023) is an individual family medicine provider in Ooltewah, Tennessee, licensed in Tennessee (63261) and active in the NPI registry since July 2006. He is enrolled in Medicare PECOS, is affiliated with Memorial Healthcare System, Inc, and maintains a secondary practice location in Wheaton.

NPPES Registry Identity

NPI1194756023
Entity TypeIndividualMale
Primary Taxonomy207Q00000X
Provider Legal NameDR. JAMES F CARSTENCredential: MD
Location Address9309 APISON PIKEOoltewah, TN 37363-4340
Mailing Address4976 Alpha LnHixson, TN 37343-5470 · (423) 497-5355 · Fax (423) 308-0281
Fax(423) 551-3563
Sole ProprietorNo
Medical School CMSUniversity Of Illinois College Of Med (chi/peor/rock/chm-urb)Graduated 1988
Enumeration DateJuly 6, 2006
Last NPPES UpdateSeptember 25, 20232 updates tracked since enumeration
NPPES CertifiedSeptember 25, 2023
NPI 1194756023 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
Licenses Licensed in TN · 63261 Licensed in IL · 036080965
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
9309 APISON PIKE, Ooltewah, TN 37363

Secondary Practice Location 1

Location 11800 N Main St Ste 102Wheaton, IL 60187-3112 · Phone (630) 260-0600 · Fax (630) 260-1370

Other Identifiers 4

Other0222075IL · Blue Cross Group Number
Medicaid036080965IL
OtherK20930IL · Medicare Ptan (individual)
OtherP00245860IL · Rr Medicare Ptan (individual)

Accepted 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. James F Carsten 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 ID9638156979
PECOS Enrollment IDI20210618000967
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 37

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.
236 services164 patients
Insertion of needle into vein for collection of blood sample 36415
This procedure involves inserting a small needle into a vein, typically in your arm, to collect a blood sample. It's a quick and simple process to help diagnose or monitor health conditions. You may feel a small prick, but discomfort is minimal.
232 services176 patients
Blood test, comprehensive group of blood chemicals 80053
A comprehensive group of blood chemicals test, also known as a comprehensive metabolic panel, is a blood test that measures your sugar level, electrolyte and fluid balance, kidney function, and liver function. This helps to check your body's overall health.
200 services159 patients
Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count 85025
A Complete Blood Cell Count is a common test that measures various components of the blood, including red cells (carry oxygen), white cells (fight infection), and platelets (help blood clot). An automated test ensures accuracy. The differential count provides detailed information about white cell types.
192 services159 patients
Blood test, thyroid stimulating hormone (tsh) 84443
A TSH blood test measures the level of thyroid stimulating hormone in your body. This hormone is produced by the pituitary gland and regulates how your thyroid works. It's a simple procedure where a small amount of blood is drawn from your arm for analysis.
168 services142 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.
139 services126 patients

Hospital Affiliations CMS Care Compare 2

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

Memorial Healthcare System, Inc

Acute Care Hospitals · Chattanooga, TN
5/5 CMS rating
OwnershipVoluntary non-profit - Church
CMS Certification Number440091
Location2525 Desales AveChattanooga, TN 37404 · Hamilton County

Erlanger Medical Center

Acute Care Hospitals · Chattanooga, TN
2/5 CMS rating
OwnershipGovernment - Hospital District or Authority
CMS Certification Number440104
Location975 E 3rd StChattanooga, TN 37403 · Hamilton County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 37363 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
$81.53 typical visit price
range $52.64 – $160.89
Typical copayment $20.38 (range $13.16 – $40.22)
Most-billed visit code 99203
Established Patient
$93.60 typical visit price
range $16.72 – $131.41
Typical copayment $23.40 (range $4.18 – $32.85)
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.

94.1/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored through an Alternative Payment Model
Quality82.59
Promoting Interoperability100
Improvement Activities40

Other Providers at the Same Location NPPES 11

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

Family Medicine
9309 APISON PIKE
OOLTEWAH, TN 37363
Nurse Practitioner (Family)
9309 APISON PIKE
OOLTEWAH, TN 37363
Nurse Practitioner (Family)
9309 APISON PIKE
OOLTEWAH, TN 37363
Family Medicine (Adult Medicine)
9309 APISON PIKE
OOLTEWAH, TN 37363
Internal Medicine
9309 APISON PIKE
OOLTEWAH, TN 37363
Family Medicine
9309 APISON PIKE
OOLTEWAH, TN 37363
Internal Medicine
9309 APISON PIKE
OOLTEWAH, TN 37363
Nurse Practitioner (Family)
9309 APISON PIKE
OOLTEWAH, TN 37363

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 James Carsten's NPI number?

The NPI number for James Carsten is 1194756023. It was assigned to this individual provider in the NPPES registry on July 6, 2006.

Where is James Carsten located?

James Carsten practices at 9309 Apison Pike, Ooltewah, TN 37363. The listed phone number is (423) 551-3562.

What is James Carsten's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is James Carsten enrolled in Medicare?

Yes. James Carsten 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 James Carsten accept?

Health plans from Alliant Health Plans, Inc., Ambetter from Arkansas Health & Wellness, Ambetter from Home State Health, Ambetter from Magnolia Health and Ambetter of Alabama and 4 other insurers list James Carsten 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 James Carsten affiliated with any hospitals?

According to CMS data, James Carsten is affiliated with Memorial Healthcare System, Inc and Erlanger Medical Center.

When was this NPI record last updated?

The NPPES record for James Carsten was last updated on September 25, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.