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THOMAS M CARTER MD
NPI 1205878055
Ophthalmology in Ponca City, OK

Active since June 12, 2006PECOS EnrolledAccepts Medicare Assignment
100/100
CMS Quality Rating
400 FAIRVIEW AVE, SUITE 21, PONCA CITY, OK 74601(580) 765-3356(580) 765-3353 Get Directions Write a Review

NPPES record last updated: May 29, 2009. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Thomas M Carter Md NPPES

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

THOMAS M CARTER MD (NPI 1205878055) is an individual ophthalmology provider in Ponca City, Oklahoma, licensed in Oklahoma (8690) and active in the NPI registry since June 2006. He is enrolled in Medicare PECOS and is a graduate of University Of Oklahoma College Of Medicine (1966).

NPPES Registry Identity

NPI1205878055
Entity TypeIndividualMale
Primary Taxonomy207W00000X
Provider Legal NameTHOMAS M CARTERCredential: MD
Location Address400 FAIRVIEW AVE, SUITE 21Ponca City, OK 74601
Mailing Address400 Fairview, Suite 21Ponca City, OK 74601 · (580) 765-3356 · Fax (580) 765-3353
Phone(580) 765-3356
Fax(580) 765-3353
Sole ProprietorNo
Medical School CMSUniversity Of Oklahoma College Of MedicineGraduated 1966
Enumeration DateJune 12, 2006
Last NPPES UpdateMay 29, 2009
✔ NPI 1205878055 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOphthalmologyAllopathic & Osteopathic Physicians
Taxonomy Code207W00000X
License✔ Licensed in OK · 8690
Definition
An ophthalmologist has the knowledge and professional skills needed to provide comprehensive eye and vision care. Ophthalmologists are medically trained to diagnose, monitor and medically or surgically treat all ocular and visual disorders. This includes problems affecting the eye and its component structures, the eyelids, the orbit and the visual pathways. In so doing, an ophthalmologist prescribes vision services, including glasses and contact lenses.
400 FAIRVIEW AVE, Ponca City, OK 74601
Open in Google Maps ↗

Other Identifiers 4

Medicare UPIND38685OK
Medicare NSC0712770001OK
Other731007150001OK · Blue Cross/blue Shield
Medicaid100116530AOK

Accepted Insurance

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

Thomas M 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 ID6406824473
PECOS Enrollment IDI20090519000054
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 8

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.
684 services502 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.
524 services502 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).
122 services120 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.
95 services92 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.
70 services70 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.
62 services43 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 74601 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
$123.06 typical visit price
range $53.00 – $162.61
Typical copayment $30.76 (range $13.25 – $40.65)
Most-billed visit code 99204
Established Patient
$66.48 typical visit price
range $16.68 – $132.40
Typical copayment $16.62 (range $4.17 – $33.10)
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
Quality100
Improvement Activities40

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.

DSK MEDICAL GROUP, PC
Clinic/Center
400 FAIRVIEW AVE, BUILDING 3, STE. 20
PONCA CITY, OK 74601
Kay County (580) 765-6647
WESLEY E. NIPPER DDS PC
Health Maintenance Organization
400 FAIRVIEW AVE, SUITE 7
PONCA CITY, OK 74601
Kay County (580) 762-7551
WESLEY E NIPPER DDS
Dentist (General Practice)
400 FAIRVIEW AVE
PONCA CITY, OK 74601
Kay County (580) 762-7551
PAMELA J POLAND M.D.
Ophthalmology
400 FAIRVIEW AVE, STE 18
PONCA CITY, OK 74601
Kay County (580) 762-5696
DR. AARON BUCHANAN D.D.S.
Dentist (General Practice)
400 FAIRVIEW AVE, SUITE #2
PONCA CITY, OK 74601
Kay County (580) 762-5335
JO ELLEN COLDIRON MD
Anesthesiology
400 FAIRVIEW AVE, STE 50 OUTPATIENT SURGICAL CTR
PONCA CITY, OK 74601
Kay County (580) 765-0673
LIONEL EVERETT BAIR II D.D.S.
Dentist (General Practice)
400 FAIRVIEW AVE, SUITE # 6
PONCA CITY, OK 74601
Kay County (580) 765-2589
GARY A DORMAN
Optometrist
400 FAIRVIEW AVE, SUITE 21
PONCA CITY, OK 74601
Kay County (580) 765-3356

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 Thomas Carter's NPI number?

The NPI number for Thomas Carter is 1205878055. It was assigned to this individual provider in the NPPES registry on June 12, 2006.

Where is Thomas Carter located?

Thomas Carter practices at 400 Fairview Ave Suite 21, Ponca City, OK 74601. The listed phone number is (580) 765-3356.

What is Thomas Carter's specialty?

The primary specialty registered for this NPI is Ophthalmology with taxonomy code 207W00000X.

Is Thomas Carter enrolled in Medicare?

Yes. Thomas 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.

What insurance does Thomas Carter accept?

Health plans from Ambetter from Arkansas Health & Wellness, Ambetter from Home State Health, Ambetter from Sunflower Health Plan, Ambetter from Superior HealthPlan and Ambetter of Oklahoma and 3 other insurers list Thomas 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.

When was this NPI record last updated?

The NPPES record for Thomas Carter was last updated on May 29, 2009. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 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.