ARLENE MARIE CARTER CRNP
NPI 1275123887
Nurse Practitioner - Community Health in Pittsburgh, PA

Q: What is Arlene Carter's NPI number?

The NPI number for Arlene Carter is 1275123887. It was assigned to this individual provider in the NPPES registry on January 19, 2021.

Q: What is Arlene Carter's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Community Health, with taxonomy code 363LC1500X.

Q: When was this NPI record last updated?

The NPPES record for Arlene Carter was last updated on January 19, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.

Active since January 19, 2021PECOS Enrolled

1789 S BRADDOCK AVE, PITTSBURGH, PA 15218(412) 436-2200 Get Directions Write a Review

NPPES record last updated: January 19, 2021. Verified against the NPPES registry weekly; last sync: November 01, 2026.

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About Arlene Marie Carter Crnp NPPES

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

ARLENE MARIE CARTER CRNP (NPI 1275123887) is an individual community health provider in Pittsburgh, Pennsylvania, licensed in Pennsylvania (SP022428) and active in the NPI registry since January 2021. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1275123887

Entity TypeIndividualFemale

Primary Taxonomy363LC1500X

Provider Legal NameARLENE MARIE CARTERCredential: CRNP

Location Address1789 S BRADDOCK AVEPittsburgh, PA 15218-1842

Mailing Address149 Nottingham DrPittsburgh, PA 15205-9735 · (304) 905-3238

Phone(412) 436-2200

Sole ProprietorNo

Enumeration DateJanuary 19, 2021

NPPES CertifiedJanuary 19, 2021

✔ NPI 1275123887 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · Community HealthPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LC1500X

License✔ Licensed in PA · SP022428

1789 S BRADDOCK AVE, Pittsburgh, PA 15218

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter Health, Ambetter Health of Delaware.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Arlene Marie Carter Crnp 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.

Medicare Billing Reassignments

Medicare enrollment records show Arlene Carter reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Personal Care Medical Associates LLC

16 mi

Hospice and Palliative Medicine

2000 CLIFFMINE RD STE 500
Pittsburgh, PA 15275

Reassigned Medicare billing, Pennsylvania enrollment
96 clinicians in this Medicare group

NPI 1922427962 (878) 201-3312

Physiatry Consultants Of Nc PLLC

427 mi

Physical Medicine & Rehabilitation

9400 MARION AVE
Morton Grove, IL 60053

Reassigned Medicare billing, Pennsylvania enrollment
59 clinicians in this Medicare group

NPI 1437736881 (855) 611-8783

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims 8

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 nursing facility care with straightforward level of medical decision making, per day, if using time, 20 minutes or more 99308

A follow-up nursing facility visit per day is a daily check-up service provided by healthcare professionals. It lasts around 15 minutes and involves assessing your health status, monitoring your recovery progress, and addressing any concerns you may have about your health or treatment.

242 services101 patients

Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes 99309

A follow-up nursing facility visit per day is a daily check-in by a healthcare professional. This 25-minute visit typically involves monitoring your health progress, addressing any concerns, and adjusting treatment plans as necessary. It's a vital part of ensuring your ongoing wellbeing.

183 services82 patients

Initial nursing facility care with moderate level of medical decision making, per day, if using time, at least 35 minutes 99305

An initial nursing facility visit per day is a service where a healthcare professional spends about 35 minutes assessing a patient's health status. This includes reviewing medical history, conducting a physical exam, and developing a care plan based on the patient's needs.

102 services92 patients

Chronic care management services, first 20 minutes of clinical staff time directed by health care professional, per calendar month 99490

Chronic care management services involve a healthcare professional directing clinical staff in managing your chronic conditions. This includes the first 20 minutes per month of services like medication management, care coordination, and health monitoring to help improve your health and quality of life.

69 services41 patients

Chronic care management services for two or more chronic conditions, additional 20 minutes of clinical staff time directed by health care professional, per calendar month 99439

Chronic Care Management services involve regular check-ins with healthcare professionals to manage two or more chronic conditions. It includes an additional 20 minutes of clinical staff time per month, directed by a healthcare professional, to ensure optimal health management.

42 services26 patients

Initial nursing facility care with high level of medical decision making, per day, if using time, 50 minutes or more 99306

An initial nursing facility visit is your first meeting with your healthcare team at a nursing facility. Lasting typically 45 minutes, this appointment involves a comprehensive health assessment and the creation of your personalized care plan. It's a crucial step to ensure your health and well-being.

41 services41 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 15218 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

$84.88 typical visit price

range $54.64 – $166.87

Typical copayment $21.22 (range $13.66 – $41.71)

Most-billed visit code 99203

Established Patient

$96.82 typical visit price

range $17.33 – $135.84

Typical copayment $24.20 (range $4.33 – $33.96)

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.

Referred Medical Equipment & Supplies CMS DME claims

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

Standard wheelchair K0001

DME-Wheelchairs · category DD000N

2 suppliers17 claims17 services$20.20 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.

NICOLAS DMITRI BROWN M.D.

Psychiatry & Neurology (Psychiatry)

1789 S BRADDOCK AVE
PITTSBURGH, PA 15218

Allegheny County (412) 342-4057

JWH INTENSIVIST, P.C.

Internal Medicine (Critical Care Medicine)

1789 S BRADDOCK AVE, SUITE 290
PITTSBURGH, PA 15218

Allegheny County (412) 371-9133

DR. MARSHA J FINO MD

Specialist

1789 S BRADDOCK AVE, SUITE 510
PITTSBURGH, PA 15218

Allegheny County (412) 244-8760

UPMC COMMUNITY MEDICINE INC

Internal Medicine

1789 S BRADDOCK AVE, SUITE 510
PITTSBURGH, PA 15218

Allegheny County (412) 244-8760

WESTERN PA FOOT AND ANKLE CENTER

Podiatrist (Primary Podiatric Medicine)

1789 S BRADDOCK AVE, SUITE 365
PITTSBURGH, PA 15218

Allegheny County (412) 371-9330

EOS COMMUNITY HEALTHCARE

Clinic/Center (Community Health)

1789 S BRADDOCK AVE
PITTSBURGH, PA 15218

Allegheny County (412) 723-1741

DR. LISA MATISKO DMD, MDS

Dentist (Endodontics)

1789 S BRADDOCK AVE, SUITE 110
PITTSBURGH, PA 15218

Allegheny County (412) 242-4022

DR. MARGARET S MORTON MD

Family Medicine

1789 S BRADDOCK AVE, STE 380
PITTSBURGH, PA 15218

Allegheny County (412) 727-6478

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 Arlene Carter's NPI number?

The NPI number for Arlene Carter is 1275123887. It was assigned to this individual provider in the NPPES registry on January 19, 2021.

Where is Arlene Carter located?

Arlene Carter practices at 1789 S Braddock Ave, Pittsburgh, PA 15218. The listed phone number is (412) 436-2200.

What is Arlene Carter's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Community Health, with taxonomy code 363LC1500X.

Is Arlene Carter enrolled in Medicare?

Yes. Arlene Carter is registered in the Medicare PECOS enrollment system.

Which organizations bill Medicare for Arlene Carter's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Arlene Carter reassigns Medicare benefits to 2 organizations: Personal Care Medical Associates LLC (Pittsburgh, PA) and Physiatry Consultants Of Nc PLLC (Morton Grove, IL). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Arlene Carter's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Arlene Carter accept?

Health plans from Ambetter Health, Ambetter Health of Delaware and Ambetter from Buckeye Health Plan list Arlene 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 Arlene Carter was last updated on January 19, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.