TROY L CARTER MD
NPI 1265596522
Ophthalmology in Abilene, TX

Active since December 21, 2006PECOS EnrolledAccepts Medicare Assignment
100/100
CMS Quality Rating
1750 PINE ST, ABILENE, TX 79601(325) 672-9000(325) 677-5389 Get Directions Write a Review

NPPES record last updated: February 7, 2014. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Troy L Carter Md NPPES

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

TROY L CARTER MD (NPI 1265596522) is an individual ophthalmology provider in Abilene, Texas, licensed in Texas (J4025) and active in the NPI registry since December 2006. He is enrolled in Medicare PECOS, is affiliated with Hendrick Medical Center, and is a graduate of University Of North Texas Hsc, College Of Osteopathic Med (1992).

NPPES Registry Identity

NPI1265596522
Entity TypeIndividualMale
Primary Taxonomy207W00000X
Provider Legal NameTROY L CARTERCredential: MD
Location Address1750 PINE STAbilene, TX 79601-3044
Mailing Address1750 Pine StAbilene, TX 79601-3044 · (325) 672-9000 · Fax (325) 677-5389
Fax(325) 677-5389
Sole ProprietorYes
Medical School CMSUniversity Of North Texas Hsc, College Of Osteopathic MedGraduated 1992
Enumeration DateDecember 21, 2006
Last NPPES UpdateFebruary 7, 2014
NPI 1265596522 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyOphthalmologyAllopathic & Osteopathic Physicians
Taxonomy Code207W00000X
License Licensed in TX · J4025
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.

1750 PINE ST, Abilene, TX 79601

Other Identifiers 3

Medicare UPING25851TX
Medicare ID-Type Unspecified00U93YTX
Medicaid100375801TX

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

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

Troy L 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 ID2163530650
PECOS Enrollment IDI20110425000817
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 19

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 complete exam of visual system 92014
An established patient complete exam of the visual system involves a thorough check of your eyes and vision. It assesses eye health, checks for diseases, and measures your ability to see clearly at different distances. It's a routine, non-invasive procedure.
839 services834 patients
Established patient problem focused exam of visual system 92012
This is a routine check-up for existing patients focusing on the visual system. It involves examining your eyes to detect any potential issues or changes in your vision. It's a crucial part of maintaining good eye health.
472 services315 patients
Photography of the retina 92250
Photography of the retina, also known as retinal imaging, is a non-invasive procedure that captures images of the back of your eye. This helps doctors identify and monitor conditions like glaucoma, macular degeneration, or diabetic retinopathy. It's painless and quick, often part of a routine eye exam.
450 services447 patients
New patient complete exam of visual system 92004
A new patient complete exam of the visual system is a thorough evaluation of your eyes and vision. It checks for any potential issues and assesses overall eye health. It includes tests for visual acuity, eye movement, and light response.
141 services141 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).
137 services136 patients
Measurement of corneal curvature and depth of eye 92136
This procedure measures the shape and depth of your eye, specifically the cornea, the clear front surface. It helps in diagnosing conditions, planning for surgeries, or fitting contact lenses. It's non-invasive and painless.
92 services68 patients

Hospital Affiliations CMS Care Compare

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

Hendrick Medical Center

Acute Care Hospitals · Abilene, TX
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number450229
Location1900 PineAbilene, TX 79601 · Taylor County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 79601 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
$126.40 typical visit price
range $54.84 – $166.88
Typical copayment $31.60 (range $13.71 – $41.72)
Most-billed visit code 99204
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.

100/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Individually scored
Quality100
Improvement Activities40
Cost100

Reported Quality Measures

Age-Related Macular Degeneration (AMD): Dilated Macular Examination
95%421 patients3/55-star benchmark: 100%
Cataract Surgery: Difference Between Planned and Final Refraction
99%270 patients4/55-star benchmark: 100%
Cataracts: 20/40 or Better Visual Acuity within 90 Days Following Cataract Surgery
100%122 patients5/55-star benchmark: 100%
Complications After Cataract Surgery
Lower rates are better for this measure.
0%270 patients
Diabetes: Eye Exam
100%585 patients5/55-star benchmark: 100%
Diabetic Retinopathy: Communication with the Physician Managing Ongoing Diabetes Care
96%199 patients4/55-star benchmark: 100%
Documentation of Current Medications in the Medical Record
100%4,346 patients5/55-star benchmark: 100%
Glaucoma Intraocular Pressure Reduction
88%65 patients
Primary Open-Angle Glaucoma (POAG): Optic Nerve Evaluation
100%145 patients
Primary Open-Angle Glaucoma (POAG): Reduction of Intraocular Pressure (IOP) by 15% OR Documentation of a Plan of Care
99%123 patients
Tobacco Use and Help with Quitting Among Adolescents
97%32 patients4/55-star benchmark: 100%
Use of High-Risk Medications in Older Adults
Lower rates are better for this measure.
Patients appropriateDiagnosis: 0% · 2,272 patients
Patients totalRate: 0% · 2,272 patients
0%2,272 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.

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.

Frames, purchases V2020
Other-Vision, Hearing, and Speech Services · category OC000N
5 suppliers16 claims16 services$48.46 avg. paid by Medicare
Sphere, trifocal, plano to plus or minus 4.00d, per lens V2300
Other-Vision, Hearing, and Speech Services · category OC000N
2 suppliers12 claims21 services$59.02 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 2

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

Technician/Technologist (Optician)
1750 PINE ST
ABILENE, TX 79601
Ophthalmology
1750 PINE ST
ABILENE, TX 79601

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 Troy Carter's NPI number?

The NPI number for Troy Carter is 1265596522. It was assigned to this individual provider in the NPPES registry on December 21, 2006.

Where is Troy Carter located?

Troy Carter practices at 1750 Pine St, Abilene, TX 79601. The listed phone number is (325) 672-9000.

What is Troy Carter's specialty?

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

Is Troy Carter enrolled in Medicare?

Yes. Troy 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 Troy Carter accept?

Health plans from Blue Cross and Blue Shield of Texas list Troy 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 Troy Carter affiliated with any hospitals?

According to CMS data, Troy Carter is affiliated with Hendrick Medical Center.

When was this NPI record last updated?

The NPPES record for Troy Carter was last updated on February 7, 2014. NPI Profile syncs with the weekly NPPES data releases published by CMS.