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DR. VALERIE CARTER M.D.
NPI 1255780383
Internal Medicine in Milwaukee, WI

Active since June 09, 2016PECOS EnrolledAccepts Medicare Assignment
93.27/100
CMS Quality Rating
9200 W WISCONSIN AVE, MILWAUKEE, WI 53226(414) 805-0812(414) 805-0855 Get Directions Write a Review

NPPES record last updated: June 28, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jun 28, 2024, Sep 25, 2019, Aug 27, 2019 (3 updates tracked since 2019).

About Dr. Valerie Carter M.d. NPPES

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

DR. VALERIE CARTER M.D. (NPI 1255780383) is an individual internal medicine provider in Milwaukee, Wisconsin, licensed in Wisconsin (71663) and active in the NPI registry since June 2016. She is enrolled in Medicare PECOS, is affiliated with Froedtert Memorial Lutheran Hospital, and is a graduate of Other (2016).

NPPES Registry Identity

NPI1255780383
Entity TypeIndividualFemale
Primary Taxonomy207R00000X
Provider Legal NameDR. VALERIE CARTERCredential: M.D.
Location Address9200 W WISCONSIN AVEMilwaukee, WI 53226-3522
Mailing Address9200 W Wisconsin AveMilwaukee, WI 53226-3522 · (414) 805-0812 · Fax (414) 805-0855
Phone(414) 805-0812
Fax(414) 805-0855
Sole ProprietorNo
Medical School CMSOtherGraduated 2016
Enumeration DateJune 9, 2016
Last NPPES UpdateJune 28, 20243 updates tracked since enumeration
NPPES CertifiedJune 28, 2024
✔ NPI 1255780383 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
License✔ Licensed in WI · 71663
Definition
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
Also ListedHospitalistTaxonomy 208M00000X · License 71663 (WI)
9200 W WISCONSIN AVE, Milwaukee, WI 53226
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Other Identifiers 1

Medicaid1255780383WI

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, Aspirus Health Plan.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. Valerie Carter M.d. 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 ID345535522
PECOS Enrollment IDI20190917003595, I20230119003094
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 7

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.

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes 99232
Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.
170 services80 patients
Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes 99233
Follow-up hospital inpatient care per day typically involves a 35-minute check-up by your healthcare provider. This service includes monitoring your health progress, adjusting your treatment plan if needed, and answering any questions you may have about your condition or care.
131 services73 patients
Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes 99223
Initial hospital inpatient care per day, typically 70 minutes, refers to the daily medical service provided to patients admitted to the hospital. This includes a comprehensive evaluation, diagnosis, treatment plan, and monitoring of your health condition. It ensures your well-being during your hospital stay.
68 services68 patients
Hospital discharge day management, more than 30 minutes 99239
Hospital discharge day management over 30 minutes involves a detailed process to ensure a smooth transition from hospital to home. It includes final examinations, discussion of your hospital stay, post-discharge instructions, and coordinating follow-up care.
59 services58 patients
Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes 99222
Initial hospital inpatient care is a service where a healthcare provider spends about 50 minutes per day overseeing your care while you're admitted in the hospital. This includes reviewing your health status, planning your treatment, and ensuring your safety and comfort.
58 services56 patients
Hospital discharge day management, 30 minutes or less 99238
Hospital discharge day management of 30 minutes or less includes finalizing your treatment, discussing your progress, and planning after-care at home. It ensures you're ready to leave the hospital and continue recovery safely.
22 services22 patients

Hospital Affiliations CMS Care Compare

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

Froedtert Memorial Lutheran Hospital

Acute Care Hospitals · Milwaukee, WI
5/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number520177
Location9200 W Wisconsin AveMilwaukee, WI 53226 · Milwaukee County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 53226 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
$123.69 typical visit price
range $53.90 – $163.24
Typical copayment $30.92 (range $13.47 – $40.81)
Most-billed visit code 99204
Established Patient
$95.41 typical visit price
range $17.40 – $133.76
Typical copayment $23.85 (range $4.35 – $33.44)
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.

93.27/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored through an Alternative Payment Model
Quality81.72
Promoting Interoperability78.03
Improvement Activities40

Referred Medical Equipment & Supplies CMS DME claims 2

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing E0431
DME-Oxygen and Supplies · category DC000N
1 supplier12 claims12 services$17.63 avg. paid by Medicare
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate E1390
DME-Oxygen and Supplies · category DC002N
1 supplier16 claims16 services$77.57 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

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.

TRACY BLAIR WANDTKE HERRMANN APNP, CNM
Advanced Practice Midwife
9200 W WISCONSIN AVE
MILWAUKEE, WI 53226
Milwaukee County (414) 805-4777
DR. ZACHARY SMITH DO
Internal Medicine (Gastroenterology)
9200 W WISCONSIN AVE
MILWAUKEE, WI 53226
Milwaukee County (414) 955-6830
DR. COLLEEN ANN CROWE M.D., M.P.H.
Emergency Medicine
9200 W WISCONSIN AVE
MILWAUKEE, WI 53226
Milwaukee County (414) 805-6469
ROBERTO MEJIAS APNP
Nurse Practitioner (Pediatrics)
9200 W WISCONSIN AVE
MILWAUKEE, WI 53226
Milwaukee County (414) 805-6600
MRS. ANNE E B LAKATOS APN-BC, APNP, RN
Nurse Practitioner (Adult Health)
9200 W WISCONSIN AVE, DEPT OF INTERNAL MEDICINE
MILWAUKEE, WI 53226
Milwaukee County (414) 805-6850
MRS. AMANDA M MANDERS APNP
Nurse Practitioner (Adult Health)
9200 W WISCONSIN AVE
MILWAUKEE, WI 53226
Milwaukee County (414) 805-6850
KATHLEEN A WATERHOUSE-SKIBICKI CRNA
Nurse Anesthetist, Certified Registered
9200 W WISCONSIN AVE
MILWAUKEE, WI 53226
Milwaukee County (414) 805-5951
ANDREA L BEQUEST PA
Physician Assistant (Medical)
9200 W WISCONSIN AVE, INTERNAL MEDICINE
MILWAUKEE, WI 53226
Milwaukee County (414) 955-0350

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 Valerie Carter's NPI number?

The NPI number for Valerie Carter is 1255780383. It was assigned to this individual provider in the NPPES registry on June 9, 2016.

Where is Valerie Carter located?

Valerie Carter practices at 9200 W Wisconsin Ave, Milwaukee, WI 53226. The listed phone number is (414) 805-0812.

What is Valerie Carter's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Is Valerie Carter enrolled in Medicare?

Yes. Valerie 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 Valerie Carter accept?

Health plans from Anthem Blue Cross and Blue Shield and Aspirus Health Plan list Valerie 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.

Is Valerie Carter affiliated with any hospitals?

According to CMS data, Valerie Carter is affiliated with Froedtert Memorial Lutheran Hospital.

When was this NPI record last updated?

The NPPES record for Valerie Carter was last updated on June 28, 2024. 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.