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SHELLY CARLTON FNP
NPI 1275088254
Nurse Practitioner - Family in Muskogee, OK

Active since August 19, 2016PECOS EnrolledAccepts Medicare Assignment
350 S 40TH ST, MUSKOGEE, OK 74401(918) 683-0753(918) 683-5677 Get Directions Write a Review

NPPES record last updated: March 20, 2020. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Mar 20, 2020, Oct 16, 2017, Aug 19, 2016 (3 updates tracked since 2016).

About Shelly Carlton Fnp NPPES

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

SHELLY CARLTON FNP (NPI 1275088254) is an individual family provider in Muskogee, Oklahoma, licensed in Oklahoma (82527) and active in the NPI registry since August 2016. She is enrolled in Medicare PECOS, is affiliated with Saint Francis Hospital Muskogee, and is a graduate of Other (2016).

NPPES Registry Identity

NPI1275088254
Entity TypeIndividualFemale
Primary Taxonomy363LF0000X
Provider Legal NameSHELLY CARLTONCredential: FNP
Location Address350 S 40TH STMuskogee, OK 74401-4915
Mailing Address505 S Main StPorter, OK 74454-1015 · (918) 683-0753 · Fax (918) 683-5677
Phone(918) 683-0753
Fax(918) 683-5677
Sole ProprietorNo
Medical School CMSOtherGraduated 2016
Enumeration DateAugust 19, 2016
Last NPPES UpdateMarch 20, 20203 updates tracked since enumeration
NPPES CertifiedMarch 20, 2020
✔ NPI 1275088254 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
License✔ Licensed in OK · 82527
350 S 40TH ST, Muskogee, OK 74401
Open in Google Maps ↗

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

Shelly Carlton Fnp 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 ID2062778343
PECOS Enrollment IDI20171102003080
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

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.

Hemoglobin a1c level 83036
Hemoglobin A1c (HbA1c) is a test that measures your average blood sugar level over the past 2-3 months. It's used to monitor how well diabetes is being controlled. High levels may indicate that your diabetes treatment plan needs adjustment.
36 services24 patients

Hospital Affiliations CMS Care Compare

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

Saint Francis Hospital Muskogee

Acute Care Hospitals · Muskogee, OK
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number370025
Location300 Rockefeller DriveMuskogee, OK 74401 · Muskogee County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 74401 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
$82.46 typical visit price
range $53.00 – $162.61
Typical copayment $20.61 (range $13.25 – $40.65)
Most-billed visit code 99203
Established Patient
$94.27 typical visit price
range $16.68 – $132.40
Typical copayment $23.56 (range $4.17 – $33.10)
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.

Reported Quality Measures

Adult Sinusitis: Computerized Tomography (CT) for Acute Sinusitis (Overuse)
Percentage of patients aged 18 years and older with a diagnosis of acute sinusitis who had a computerized tomography (CT) scan of the paranasal sinuses ordered at the time of diagnosis or received within 28 days after date of diagnosis
Lower rates are better for this measure.
0%38 patients
Breast Cancer Screening
Percentage of women 50-74 years of age who had a mammogram to screen for breast cancer
48%127 patients3/55-star benchmark: 92%
Care Plan
Percentage of patients aged 65 years and older who have an advance care plan or surrogate decision maker documented in the medical record that an advance care plan was discussed but the patient did not wish or was not able to name a surrogate decision maker…
1%252 patients1/55-star benchmark: 100%
Colorectal Cancer Screening
Percentage of adults 50-75 years of age who had appropriate screening for colorectal cancer
25%226 patients2/55-star benchmark: 85%
Diabetes: Eye Exam
Percentage of patients 18-75 years of age with diabetes who had a retinal or dilated eye exam by an eye care professional during the measurement period or a negative retinal exam (no evidence of retinopathy) in the 12 months prior to the measurement period
37%101 patients2/55-star benchmark: 100%
Documentation of Current Medications in the Medical Record
Percentage of visits for patients aged 18 years and older for which the eligible professional or eligible clinician attests to documenting a list of current medications using all immediate resources available on the date of the encounter.
97%733 patients4/55-star benchmark: 100%
e-Prescribing
At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology.
97%1,202 patients4/55-star benchmark: 99%
Health Information Exchange
The MIPS eligible clinician that transitions or refers their patient to another setting of care or health care clinician (1) uses CEHRT to create a summary of care record; and (2) electronically transmits such summary to a receiving health care clinician for…
54%170 patients3/55-star benchmark: 88%
Medication Reconciliation
The MIPS eligible clinician performs medication reconciliation for at least one transition of care in which the patient is transitioned into the care of the MIPS eligible clinician.
96%85 patients4/55-star benchmark: 100%
Patient-Specific Education
The MIPS eligible clinician must use clinically relevant information from CEHRT to identify patient-specific educational resources and provide access to those materials to at least one unique patient seen by the MIPS eligible clinician.
68%482 patients3/55-star benchmark: 97%
Provide Patient Access
At least one patient seen by the MIPS eligible clinician during the performance period is provided timely access to view online, download, and transmit to a third party their health information subject to the MIPS eligible clinician's discretion to withhold…
84%482 patients4/55-star benchmark: 100%
Secure Messaging
For at least one unique patient seen by the MIPS eligible clinician during the performance period, a secure message was sent using the electronic messaging function of CEHRT to the patient (or the patient-authorized representative), or in response to a secure…
8%482 patients1/55-star benchmark: 89%
View, Download, or Transmit (VDT)
At least one patient seen by the MIPS eligible clinician during the performance period (or patient-authorized representative) views, downloads or transmits their health information to a third party during the performance period.
15%482 patients
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 8

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
2 suppliers11 claims11 services$21.28 avg. paid by Medicare
Nebulizer, with compressor E0570
DME-Other DME · category DE000N
3 suppliers29 claims31 services$8.06 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
2 suppliers14 claims14 services$119.54 avg. paid by Medicare
Arformoterol, inhalation solution, fda approved final product, non-compounded, administered through dme, unit dose form, 15 micrograms J7605
DME-Drugs Administered Through DME · category DG006N
1 supplier12 claims720 services$4.52 avg. paid by Medicare
Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 1 mg J7613
DME-Drugs Administered Through DME · category DG006N
2 suppliers13 claims1,602 services$0.02 avg. paid by Medicare
Budesonide, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose form, up to 0.5 mg J7626
DME-Drugs Administered Through DME · category DG000N
1 supplier12 claims720 services$0.81 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.

IFEOMA NNEKA MOZIE AGACNP
Nurse Practitioner (Acute Care)
350 S 40TH ST
MUSKOGEE, OK 74401
Muskogee County (918) 683-0753
CARDIOLOGY CLINIC OF MUSKOGEE, INC.
Internal Medicine
350 S 40TH ST, CCOM MEDICAL GROUP
MUSKOGEE, OK 74401
Muskogee County (918) 683-0753
DR. HENRY G CO M.D.
Internal Medicine
350 S 40TH ST
MUSKOGEE, OK 74401
Muskogee County (918) 683-0753
ROBERT LEE JONES JR. APRN-CNP
Nurse Practitioner (Family)
350 S 40TH ST
MUSKOGEE, OK 74401
Muskogee County (918) 683-0753
DR. MAXIMO LEBUMFACIL FERNAN JR. MD
Internal Medicine (Pulmonary Disease)
350 S 40TH ST
MUSKOGEE, OK 74401
Muskogee County (918) 683-0753
DR. WENDELL N WILLIAMS MD
Internal Medicine (Cardiovascular Disease)
350 S 40TH ST
MUSKOGEE, OK 74401
Muskogee County (918) 683-0753
JACK W. CASAS M.D.
Internal Medicine (Interventional Cardiology)
350 S 40TH ST
MUSKOGEE, OK 74401
Muskogee County (918) 683-0753
AUGUSTINA AGADAGBA CNP
Nurse Practitioner (Family)
350 S 40TH ST
MUSKOGEE, OK 74401
Muskogee County (918) 683-0753

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 Shelly Carlton's NPI number?

The NPI number for Shelly Carlton is 1275088254. It was assigned to this individual provider in the NPPES registry on August 19, 2016.

Where is Shelly Carlton located?

Shelly Carlton practices at 350 S 40th St, Muskogee, OK 74401. The listed phone number is (918) 683-0753.

What is Shelly Carlton's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Is Shelly Carlton enrolled in Medicare?

Yes. Shelly Carlton 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 Shelly Carlton 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 4 other insurers list Shelly 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.

Is Shelly Carlton affiliated with any hospitals?

According to CMS data, Shelly Carlton is affiliated with Saint Francis Hospital Muskogee.

When was this NPI record last updated?

The NPPES record for Shelly Carlton was last updated on March 20, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.