DR. JOHN R CARUSO M.D.
NPI 1285654632
Neurological Surgery in Hagerstown, MD

Active since July 20, 2006PECOS EnrolledAccepts Medicare Assignment
94.1/100
CMS Quality Rating
17 WESTERN MARYLAND PKWY, HAGERSTOWN, MD 21740(301) 797-9240(301) 797-4119 Get Directions Write a Review

NPPES record last updated: June 29, 2017. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Dr. John R Caruso M.d. NPPES

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

DR. JOHN R CARUSO M.D. (NPI 1285654632) is an individual neurological surgery provider in Hagerstown, Maryland, licensed in Maryland (D0051043) and active in the NPI registry since July 2006. He is enrolled in Medicare PECOS, is affiliated with Berkeley Medical Center, and is a graduate of Eastern Virginia Medical School (1990).

NPPES Registry Identity

NPI1285654632
Entity TypeIndividualMale
Primary Taxonomy207T00000X
Provider Legal NameDR. JOHN R CARUSOCredential: M.D.
Location Address17 WESTERN MARYLAND PKWYHagerstown, MD 21740-5146
Mailing Address19808 Blue Heron LnHagerstown, MD 21742-1603 · (301) 745-3948
Fax(301) 797-4119
Sole ProprietorNo
Medical School CMSEastern Virginia Medical SchoolGraduated 1990
Enumeration DateJuly 20, 2006
Last NPPES UpdateJune 29, 2017
NPI 1285654632 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyNeurological SurgeryAllopathic & Osteopathic Physicians
Taxonomy Code207T00000X
Licenses Licensed in MD · D0051043 Licensed in WV · 18854
Definition

A neurological surgeon provides the operative and non-operative management (i.e., prevention, diagnosis, evaluation, treatment, critical care, and rehabilitation) of disorders of the central, peripheral, and autonomic nervous systems, including their supporting structures and vascular supply; the evaluation and treatment of pathological processes which modify function or activity of the nervous system; and the operative and non-operative management of pain. A neurological surgeon treats patients with disorders of the nervous system; disorders of the brain, meninges, skull, and their blood supply, including the extracranial carotid and vertebral arteries; disorders of the pituitary gland; disorders of the spinal cord, meninges, and vertebral column, including those which may require treatment by spinal fusion or instrumentation; and disorders of the cranial and spinal nerves throughout their distribution.

17 WESTERN MARYLAND PKWY, Hagerstown, MD 21740

Other Identifiers 9

OtherW2660001MD · Md Blue Shield Regional
Medicaid138304300MD
Medicare UPING31374MD
Medicare PIN602L041DMD
Other400443PA · Pa Blue Shield Md Loc
Other145619PA · Pa Blue Shield Pa Loc
Medicare PIN001613M0TPA
Other68556206MD · Md Blue Shield Traditiona
Other140005740Rr Medicare

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

Dr. John R Caruso 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 ID5496648255
PECOS Enrollment IDI20110314000511, I20170804002642
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 11

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.

Fusion of additional segment of spine 22614
Fusion of an additional segment of the spine is a surgical procedure to join two or more vertebrae together. This is done to stabilize the spine and reduce pain or correct a deformity. The procedure involves using bone grafts, rods, or screws to secure the spine.
42 services14 patients
Partial removal of spine bone with release of lower spinal cord and/or nerves, 1 segment 63047
This procedure involves removing part of a spine bone to alleviate pressure on the lower spinal cord and/or nerves. It targets a single segment of the spine, improving mobility and reducing pain. It's a common treatment for conditions like herniated discs or spinal stenosis.
31 services31 patients
Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
30 services28 patients
Partial removal of spine bone with release of spinal cord and/or nerves, each additional segment 63048
This procedure involves the partial removal of a bone in your spine to alleviate pressure on your spinal cord or nerves. It may be performed on multiple spine segments depending on your condition. The aim is to improve mobility and reduce pain or discomfort.
26 services22 patients
New patient office or other outpatient visit with a high level of medical decision making, if using time, 60 minutes or more 99205
This is a first-time patient visit where a healthcare professional spends 60-74 minutes with you. It involves a comprehensive evaluation, including your medical history and current health condition. They'll also advise on preventive health measures and formulate a treatment plan if needed.
19 services19 patients
Placement of stabilizing device to back, 3-6 spine bone segments 22842
This procedure involves placing a device on your back to stabilize 3-6 spine bone segments. It aids in maintaining spine alignment and reducing pain. The device is secured to the bones, providing support and promoting healing.
16 services16 patients

Hospital Affiliations CMS Care Compare 2

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

Berkeley Medical Center

Acute Care Hospitals · Martinsburg, WV
1/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number510008
Location2500 Hospital DriveMartinsburg, WV 25401 · Berkeley County
Emergency services Birthing friendly

Jefferson Medical Center

Critical Access Hospitals · Ranson, WV
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number511319
Location300 South Preston StreetRanson, WV 25438 · Jefferson County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 21740 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
$133.05 typical visit price
range $57.99 – $175.57
Typical copayment $33.26 (range $14.49 – $43.89)
Most-billed visit code 99204
Established Patient
$72.23 typical visit price
range $18.66 – $143.02
Typical copayment $18.05 (range $4.66 – $35.75)
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.

94.1/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored through an Alternative Payment Model
Quality78.46
Promoting Interoperability100
Improvement Activities40

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.

Anesthesiology (Pain Medicine)
17 WESTERN MARYLAND PKWY, 100
HAGERSTOWN, MD 21740
Physician Assistant
17 WESTERN MARYLAND PKWY, SUITE 100
HAGERSTOWN, MD 21740
Physical Therapist
17 WESTERN MARYLAND PKWY
HAGERSTOWN, MD 21740
Radiology (Neuroradiology)
17 WESTERN MARYLAND PKWY, SUITE 101
HAGERSTOWN, MD 21740
Physical Therapist
17 WESTERN MARYLAND PKWY, SUITE 100
HAGERSTOWN, MD 21740
Physical Therapist
17 WESTERN MARYLAND PKWY, SUITE 100
HAGERSTOWN, MD 21740
Neurological Surgery
17 WESTERN MARYLAND PKWY, SUITE 100
HAGERSTOWN, MD 21740
Neurological Surgery
17 WESTERN MARYLAND PKWY
HAGERSTOWN, MD 21740

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 John Caruso's NPI number?

The NPI number for John Caruso is 1285654632. It was assigned to this individual provider in the NPPES registry on July 20, 2006.

Where is John Caruso located?

John Caruso practices at 17 Western Maryland Pkwy, Hagerstown, MD 21740. The listed phone number is (301) 797-9240.

What is John Caruso's specialty?

The primary specialty registered for this NPI is Neurological Surgery with taxonomy code 207T00000X.

Is John Caruso enrolled in Medicare?

Yes. John Caruso 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 John Caruso accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Meridian, CareSource and Highmark Blue Cross Blue Shield West Virginia and 1 other insurer list John Caruso 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 John Caruso affiliated with any hospitals?

According to CMS data, John Caruso is affiliated with Berkeley Medical Center and Jefferson Medical Center.

When was this NPI record last updated?

The NPPES record for John Caruso was last updated on June 29, 2017. NPI Profile syncs with the weekly NPPES data releases published by CMS.