ROXANA I CARCELEN MD
NPI 1306801543
Internal Medicine - Pulmonary Disease in Birmingham, AL

Q: What is Roxana Carcelen's NPI number?

The NPI number for Roxana Carcelen is 1306801543. It was assigned to this individual provider in the NPPES registry on April 19, 2006.

Q: What is Roxana Carcelen's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Pulmonary Disease, with taxonomy code 207RP1001X.

Q: When was this NPI record last updated?

The NPPES record for Roxana Carcelen was last updated on February 1, 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.

Active since April 19, 2006PECOS EnrolledAccepts Medicare Assignment

96.24/100

CMS Quality Rating

619 19TH ST S, BIRMINGHAM, AL 35249(205) 934-4011 Get Directions Write a Review

NPPES record last updated: February 1, 2024. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Roxana I Carcelen Md NPPES

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

ROXANA I CARCELEN MD (NPI 1306801543) is an individual pulmonary disease provider in Birmingham, Alabama, licensed in Alabama (16369) and active in the NPI registry since April 2006. She is enrolled in Medicare PECOS, maintains 2 additional practice locations, and is a graduate of University College Of Medicine (1995).

NPPES Registry Identity

NPI1306801543

Entity TypeIndividualFemale

Primary Taxonomy207RP1001X

Provider Legal NameROXANA I CARCELENCredential: MD

Location Address619 19TH ST SBirmingham, AL 35249-8718

Mailing AddressPo Box 55310Birmingham, AL 35255-5310

Phone(205) 934-4011

Sole ProprietorNo

Medical School CMSUniversity College Of MedicineGraduated 1995

Enumeration DateApril 19, 2006

Last NPPES UpdateFebruary 1, 2024

NPPES CertifiedJune 28, 2023

✔ NPI 1306801543 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · Pulmonary DiseaseAllopathic & Osteopathic Physicians

Taxonomy Code207RP1001X

License✔ Licensed in AL · 16369

Definition

An internist who treats diseases of the lungs and airways. The pulmonologist diagnoses and treats cancer, pneumonia, pleurisy, asthma, occupational and environmental diseases, bronchitis, sleep disorders, emphysema and other complex disorders of the lungs.

619 19TH ST S, Birmingham, AL 35249

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Secondary Practice Locations 2

Location 11022 1st St N, Suite 401Alabaster, AL 35007-8718 · Phone (205) 664-5935 · Fax (205) 664-5233

Location 22000 6th Ave SBirmingham, AL 35233-2110 · Phone (205) 996-5864 · Fax (205) 801-8105

Other Identifiers 2

Medicaid000035508AL

Medicaid000034731AL

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of Alabama.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

Roxana I Carcelen 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 ID4880671601

PECOS Enrollment IDI20100805000801

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 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.

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.

96 services77 patients

New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204

This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.

36 services36 patients

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214

31 services30 patients

Sleep study in sleep lab with continuous airway pressure (6 years or older) 95811

A sleep study in a sleep lab with continuous airway pressure is a test for individuals aged 6 and above. It monitors your sleep patterns to check for disorders like sleep apnea. Continuous airway pressure helps keep your airways open while you sleep, improving your breathing.

24 services23 patients

New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204

18 services18 patients

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

17 services17 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 35249 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

$122.31 typical visit price

range $52.65 – $161.63

Typical copayment $30.57 (range $13.16 – $40.40)

Most-billed visit code 99204

Established Patient

$93.72 typical visit price

range $16.56 – $131.65

Typical copayment $23.43 (range $4.14 – $32.91)

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.

96.24/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Scored through an Alternative Payment Model

Quality

74.02

Promoting Interoperability

100

Improvement Activities

Reported Quality Measures

Pneumococcal Vaccination Status for Older Adults

Percentage of patients 65 years of age and older who have ever received a pneumococcal vaccine

75%527 patients4/55-star benchmark: 90%

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 27

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

Tubing with integrated heating element for use with positive airway pressure device A4604

DME-Other DME · category DE001N

10 suppliers65 claims65 services$32.32 avg. paid by Medicare

Administration set, with small volume nonfiltered pneumatic nebulizer, disposable A7003

DME-Other DME · category DE000N

1 supplier41 claims82 services$1.34 avg. paid by Medicare

Small volume nonfiltered pneumatic nebulizer, disposable A7004

DME-Other DME · category DE000N

1 supplier41 claims82 services$0.95 avg. paid by Medicare

Aerosol mask, used with dme nebulizer A7015

DME-Other DME · category DE000N

3 suppliers43 claims43 services$1.08 avg. paid by Medicare

Full face mask used with positive airway pressure device, each A7030

DME-Other DME · category DE001N

11 suppliers131 claims131 services$76.53 avg. paid by Medicare

Face mask interface, replacement for full face mask, each A7031

DME-Other DME · category DE001N

9 suppliers139 claims343 services$30.80 avg. paid by Medicare

Cushion for use on nasal mask interface, replacement only, each A7032

DME-Other DME · category DE001N

11 suppliers100 claims489 services$16.98 avg. paid by Medicare

Pillow for use on nasal cannula type interface, replacement only, pair A7033

DME-Other DME · category DE001N

11 suppliers75 claims417 services$13.03 avg. paid by Medicare

Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap A7034

DME-Other DME · category DE001N

16 suppliers170 claims170 services$47.19 avg. paid by Medicare

Headgear used with positive airway pressure device A7035

DME-Other DME · category DE001N

17 suppliers170 claims170 services$15.12 avg. paid by Medicare

Chinstrap used with positive airway pressure device A7036

DME-Other DME · category DE001N

3 suppliers13 claims13 services$9.60 avg. paid by Medicare

Tubing used with positive airway pressure device A7037

DME-Other DME · category DE001N

15 suppliers222 claims222 services$11.22 avg. paid by Medicare

Filter, disposable, used with positive airway pressure device A7038

DME-Other DME · category DE001N

16 suppliers296 claims1,510 services$1.77 avg. paid by Medicare

Filter, non disposable, used with positive airway pressure device A7039

DME-Other DME · category DE001N

13 suppliers48 claims48 services$5.13 avg. paid by Medicare

Water chamber for humidifier, used with positive airway pressure device, replacement, each A7046

DME-Other DME · category DE001N

11 suppliers118 claims118 services$11.14 avg. paid by Medicare

Portable oxygen contents, gaseous, 1 month's supply = 1 unit E0443

DME-Oxygen and Supplies · category DC000N

1 supplier12 claims12 services$43.34 avg. paid by Medicare

Home ventilator, any type, used with non-invasive interface, (e.g., mask, chest shell) E0466

DME-Other DME · category DE005N

3 suppliers38 claims38 services$775.73 avg. paid by Medicare

Respiratory assist device, bi-level pressure capability, with back-up rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device) E0471

DME-Other DME · category DE001N

1 supplier11 claims11 services$198.08 avg. paid by Medicare

Humidifier, heated, used with positive airway pressure device E0562

DME-Other DME · category DE001N

8 suppliers29 claims29 services$121.84 avg. paid by Medicare

Nebulizer, with compressor E0570

DME-Other DME · category DE000N

4 suppliers48 claims48 services$5.60 avg. paid by Medicare

Continuous positive airway pressure (cpap) device E0601

DME-Other DME · category DE001N

11 suppliers246 claims268 services$32.31 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

4 suppliers148 claims153 services$77.99 avg. paid by Medicare

Portable oxygen concentrator, rental E1392

DME-Oxygen and Supplies · category DC002N

3 suppliers107 claims107 services$33.60 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

5 suppliers26 claims5,460 services$0.03 avg. paid by Medicare

Albuterol, up to 2.5 mg and ipratropium bromide, up to 0.5 mg, fda-approved final product, non-compounded, administered through dme J7620

DME-Drugs Administered Through DME · category DG006N

5 suppliers50 claims5,220 services$0.09 avg. paid by Medicare

Portable gaseous oxygen system, rental; home compressor used to fill portable oxygen cylinders; includes portable containers, regulator, flowmeter, humidifier, cannula or mask, and tubing K0738

DME-Oxygen and Supplies · category DC000N

1 supplier18 claims18 services$34.64 avg. paid by Medicare

Pharmacy dispensing fee for inhalation drug(s); per 30 days Q0513

DME-Other DME · category DE000N

9 suppliers73 claims73 services$24.25 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.

GARRETT WALKER COLBY MD

Radiology (Diagnostic Radiology)

619 19TH ST S, JT N342
BIRMINGHAM, AL 35249

Jefferson County (205) 934-3108

SHANA MONIKA MACHADO D.O.

Internal Medicine (Nephrology)

619 19TH ST S
BIRMINGHAM, AL 35249

Jefferson County (205) 934-4011

RIAZ MOHAMMED KARUKAPPADATH

Anesthesiology

619 19TH ST S
BIRMINGHAM, AL 35249

Jefferson County (205) 934-4011

SABRINA GODDARD

Surgery (Surgical Critical Care)

619 19TH ST S
BIRMINGHAM, AL 35249

Jefferson County (205) 934-4011

MR. RYNE SCOTT DUREN CRNP

Nurse Practitioner (Acute Care)

619 19TH ST S
BIRMINGHAM, AL 35249

Jefferson County (205) 996-0586

DR. JOSHUA JAMES TESSIN PHARMD

Pharmacist

619 19TH ST S
BIRMINGHAM, AL 35249

Jefferson County (205) 934-5350

LEONA COUNCIL MD

Pathology (Anatomic Pathology & Clinical Pathology)

619 19TH ST S
BIRMINGHAM, AL 35249

Jefferson County (205) 934-5038

TIMOTHY TODD FLEENOR M.D.

Emergency Medicine

619 19TH ST S
BIRMINGHAM, AL 35249

Jefferson County (205) 934-5004

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 Roxana Carcelen's NPI number?

The NPI number for Roxana Carcelen is 1306801543. It was assigned to this individual provider in the NPPES registry on April 19, 2006.

Where is Roxana Carcelen located?

Roxana Carcelen practices at 619 19th St S, Birmingham, AL 35249. The listed phone number is (205) 934-4011.

What is Roxana Carcelen's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Pulmonary Disease, with taxonomy code 207RP1001X.

Is Roxana Carcelen enrolled in Medicare?

Yes. Roxana Carcelen 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 Roxana Carcelen accept?

Health plans from Blue Cross and Blue Shield of Alabama list Roxana Carcelen 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 Roxana Carcelen was last updated on February 1, 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.