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THOMAS R CARTER MD
NPI 1255316287
Orthopaedic Surgery in Phoenix, AZ

Active since December 13, 2005PECOS EnrolledAccepts Medicare Assignment
88.44/100
CMS Quality Rating
2222 E HIGHLAND AVE, STE 300, PHOENIX, AZ 85016(602) 277-6211(866) 242-5309 Get Directions Write a Review

NPPES record last updated: February 11, 2013. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Thomas R Carter Md NPPES

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

THOMAS R CARTER MD (NPI 1255316287) is an individual orthopaedic surgery provider in Phoenix, Arizona, licensed in Arizona (18672) and active in the NPI registry since December 2005. He is enrolled in Medicare PECOS and is a graduate of University Of Pittsburgh School Of Medicine (1983).

NPPES Registry Identity

NPI1255316287
Entity TypeIndividualMale
Primary Taxonomy207X00000X
Provider Legal NameTHOMAS R CARTERCredential: MD
Location Address2222 E HIGHLAND AVE, STE 300Phoenix, AZ 85016-4872
Mailing Address2222 E Highland Ave, Ste 300Phoenix, AZ 85016-4872 · (602) 277-6211 · Fax (866) 242-5309
Phone(602) 277-6211
Fax(866) 242-5309
Sole ProprietorNo
Medical School CMSUniversity Of Pittsburgh School Of MedicineGraduated 1983
Enumeration DateDecember 13, 2005
Last NPPES UpdateFebruary 11, 2013
✔ NPI 1255316287 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOrthopaedic SurgeryAllopathic & Osteopathic Physicians
Taxonomy Code207X00000X
License✔ Licensed in AZ · 18672
Definition
An orthopaedic surgeon is trained in the preservation, investigation and restoration of the form and function of the extremities, spine and associated structures by medical, surgical and physical means. An orthopaedic surgeon is involved with the care of patients whose musculoskeletal problems include congenital deformities, trauma, infections, tumors, metabolic disturbances of the musculoskeletal system, deformities, injuries and degenerative diseases of the spine, hands, feet, knee, hip, shoulder and elbow in children and adults. An orthopaedic surgeon is also concerned with primary and secondary muscular problems and the effects of central or peripheral nervous system lesions of the musculoskeletal system.
2222 E HIGHLAND AVE, Phoenix, AZ 85016
Open in Google Maps ↗

Other Identifiers 3

Medicaid296013AZ
Medicare PINZWCJCV02
Medicare UPINE45410

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arizona Complete Health, Blue Cross Blue Shield of Arizona, Oscar Health Plan, Inc. 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 R 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 ID345137584
PECOS Enrollment IDI20060227000779
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 9

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, 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.
124 services15 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.
46 services46 patients
Aspiration and/or injection of fluid from large joint 20610
This procedure involves using a needle to remove (aspiration) or introduce (injection) fluid into a large joint like the knee or hip. It can help diagnose conditions, relieve discomfort, or deliver medication directly to the joint.
40 services25 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.
40 services31 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.
32 services32 patients
X-ray of knee, 3 views 73562
An X-ray of the knee, 3 views, is a non-invasive imaging test. It uses a small amount of radiation to produce images of the knee from three different angles. This helps medical professionals to diagnose and monitor conditions like arthritis, fractures, or infections. The process is quick and painless.
31 services29 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 85016 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
$85.89 typical visit price
range $55.44 – $168.60
Typical copayment $21.47 (range $13.86 – $42.15)
Most-billed visit code 99203
Established Patient
$69.24 typical visit price
range $17.72 – $137.41
Typical copayment $17.31 (range $4.43 – $34.35)
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.

88.44/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Promoting Interoperability98
Improvement Activities40
Cost59.36

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.

THE ORTHOPEDIC CLINIC ASSOCIATION, INC
Orthopaedic Surgery
2222 E HIGHLAND AVE, STE 300
PHOENIX, AZ 85016
Maricopa County (602) 277-6211
ORTHOPEDIC SPECIALISTS OF NORTH AMERICA, PLLC
Orthopaedic Surgery
2222 E HIGHLAND AVE, STE 425
PHOENIX, AZ 85016
Maricopa County (602) 667-6640
DESERT FOOT SURGEONS P L L C
Podiatrist (Primary Podiatric Medicine)
2222 E HIGHLAND AVE, SUITE 206
PHOENIX, AZ 85016
Maricopa County (602) 995-1169
JON H WHISLER MD
Orthopaedic Surgery
2222 E HIGHLAND AVE, STE 300
PHOENIX, AZ 85016
Maricopa County (602) 277-6211
LYNDSAY JEAN WILLMOTT MD
Obstetrics & Gynecology (Gynecologic Oncology)
2222 E HIGHLAND AVE, SUITE 400
PHOENIX, AZ 85016
Maricopa County (602) 277-4868
JONATHAN SEIDBERG DPT
Physical Therapist
2222 E HIGHLAND AVE, SUITE 200
PHOENIX, AZ 85016
Maricopa County (602) 595-6180
HARRISON WILLIAMS DPT
Physical Therapist
2222 E HIGHLAND AVE, SUITE 200
PHOENIX, AZ 85016
Maricopa County (602) 595-6180
KEERAT SINGH MD
Orthopaedic Surgery (Adult Reconstructive Orthopaedic Surgery)
2222 E HIGHLAND AVE
PHOENIX, AZ 85016
Maricopa County (602) 277-6211

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 1255316287. It was assigned to this individual provider in the NPPES registry on December 13, 2005.

Where is Thomas Carter located?

Thomas Carter practices at 2222 E Highland Ave Ste 300, Phoenix, AZ 85016. The listed phone number is (602) 277-6211.

What is Thomas Carter's specialty?

The primary specialty registered for this NPI is Orthopaedic Surgery with taxonomy code 207X00000X.

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 Arizona Complete Health, Blue Cross Blue Shield of Arizona, Oscar Health Plan, Inc. and UnitedHealthcare 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 February 11, 2013. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 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.