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DR. CHAD JOSEPH CARLTON M.D.
NPI 1245561109
Surgery in Plano, TX

Active since January 15, 2010PECOS Enrolled
4800 HEDGCOXE RD STE 200, PLANO, TX 75024(972) 232-7171(972) 674-8360 Get Directions Write a Review

NPPES record last updated: April 1, 2025. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Apr 1, 2025, Mar 1, 2019, Mar 17, 2018 and 1 more (4 updates tracked since 2017).

About Dr. Chad Joseph Carlton M.d. NPPES

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

DR. CHAD JOSEPH CARLTON M.D. (NPI 1245561109) is an individual surgery provider in Plano, Texas, licensed in Texas (N5606) and active in the NPI registry since January 2010. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1245561109
Entity TypeIndividualMale
Primary Taxonomy208600000X
Provider Legal NameDR. CHAD JOSEPH CARLTONCredential: M.D.
Location Address4800 HEDGCOXE RD STE 200Plano, TX 75024-2402
Mailing Address5600 W Lovers Ln Ste 116Dallas, TX 75209-4360 · (972) 232-7171 · Fax (972) 674-8360
Phone(972) 232-7171
Fax(972) 674-8360
Sole ProprietorNo
Enumeration DateJanuary 15, 2010
Last NPPES UpdateApril 1, 20254 updates tracked since enumeration
NPPES CertifiedApril 1, 2025
✔ NPI 1245561109 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySurgeryAllopathic & Osteopathic Physicians
Taxonomy Code208600000X
License✔ Licensed in TX · N5606
Definition
A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery.
4800 HEDGCOXE RD STE 200, Plano, TX 75024
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Other Identifiers 3

Medicaid2828006-01TX
Medicaid2828006-02TX
Medicaid282800603TX

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Baylor Scott and White Health Plan, Blue Cross and Blue Shield of Texas.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Chad Joseph Carlton M.d. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 75024 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
$84.92 typical visit price
range $54.84 – $166.88
Typical copayment $21.23 (range $13.71 – $41.72)
Most-billed visit code 99203
Established Patient
$68.55 typical visit price
range $17.52 – $136.11
Typical copayment $17.13 (range $4.38 – $34.02)
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

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…
100%73 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.

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.

INFANT FEEDING ASSOCIATES OF NORTH TEXAS, LLC
Speech-Language Pathologist
4800 HEDGCOXE RD STE 200
PLANO, TX 75024
Collin County (972) 836-7080
CORY NATHAN COSTELLO M.D.
Family Medicine
4800 HEDGCOXE RD STE 200
PLANO, TX 75024
Collin County (469) 800-6120

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 Chad Carlton's NPI number?

The NPI number for Chad Carlton is 1245561109. It was assigned to this individual provider in the NPPES registry on January 15, 2010.

Where is Chad Carlton located?

Chad Carlton practices at 4800 Hedgcoxe Rd Ste 200, Plano, TX 75024. The listed phone number is (972) 232-7171.

What is Chad Carlton's specialty?

The primary specialty registered for this NPI is Surgery with taxonomy code 208600000X.

Is Chad Carlton enrolled in Medicare?

Yes. Chad Carlton is registered in the Medicare PECOS enrollment system.

What insurance does Chad Carlton accept?

Health plans from Baylor Scott and White Health Plan and Blue Cross and Blue Shield of Texas list Chad 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.

When was this NPI record last updated?

The NPPES record for Chad Carlton was last updated on April 1, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 months 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.