SUZANNA M CARLTON FNP
NPI 1336695584
Nurse Practitioner - Family in Shelbyville, IN
NPI Status: Active since August 28, 2016
Contact Information
2451 INTELLIPLEX DR STE 215
SHELBYVILLE, IN
ZIP 46176
Phone: (317) 421-1917
Fax: (317) 825-5303
- Individual
- Female
- Years of Experience 10
- Nurse Practitioner
- Family
- Accepts Insurance
- Accepts Medicare Approved Payment
- PECOS Enrolled
About SUZANNA CARLTON
This page provides the complete NPI Profile along with additional information for Suzanna Carlton, a provider established in Shelbyville, Indiana with a medical specialization in Nurse Practitioner, focusing in family and more than 10 years of experience. The healthcare provider is registered in the NPI registry with number 1336695584 assigned on August 2016. The practitioner's primary taxonomy code is 363LF0000X with license number 71006547A (IN). The provider is registered as an individual and her NPI record was last updated one year ago.
- NPI
- 1336695584
- Provider Name
- SUZANNA M CARLTON FNP
- Gender
- Female
- Entity Type
- Individual
- Location Address
- 2451 INTELLIPLEX DR STE 215 SHELBYVILLE, IN 46176
- Location Phone
- (317) 421-1917
- Location Fax
- (317) 825-5303
- Mailing Address
- 2451 INTELLIPLEX DR SHELBYVILLE, IN 46176
- Mailing Phone
- (317) 392-3211
- Medical School Name
- OTHER
- Graduation Year
- 2016
- Is Sole Proprietor?
- Yes
- Enumeration Date
- 08-28-2016
- Last Update Date
- 08-13-2024
- Code Navigator
A nurse practitioner (NP) like Suzanna Carlton is an experienced registered nurse with a master’s or doctoral degree and advanced clinical training. Nurse practitioners can work in many different specialties including primary care, pediatrics, cardiology, emergency, women’s health, oncology or geriatrics. Nurse practitioners provide services like physical exams, order laboratory tests, manage diseases, write prescriptions, etc.
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Nurse Practitioner Family
- Taxonomy Code
- 363LF0000X
- Type
- Physician Assistants & Advanced Practice Nursing Providers
- License No.
- 71006547A
- License State
- IN
Secondary Taxonomies
The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.
No. | Taxonomy Code | Type | Classification / Specialization |
License No. (State) |
---|---|---|---|---|
1 | 363LF0000X | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | 28164801A (IN) |
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Bronze First 7500 $25 Generic Drugs - HMO
- Bronze First 7500 $25 Generic Drugs Adult Vision & Fitness - HMO
- Diabetes Gold 1100 $0 Select Drugs & Specialized Services - HMO
- Diabetes Gold 1100 $0 Select Drugs & Specialized Services Adult Vision & Fitness - HMO
- Diabetes Silver 4000 $0 Select Drugs & Specialized Services - HMO
- Diabetes Silver 4000 $0 Select Drugs & Specialized Services Adult Vision & Fitness - HMO
- Gold 1500 $15 Generic Drugs - HMO
- Gold 1500 $15 Generic Drugs Adult Vision & Fitness - HMO
- HDHP Preventive Silver 5500 $0 Select Drugs - HMO
- Healthy Heart Gold 1500 $0 Select Drugs & Specialized Services - HMO
- Healthy Heart Gold 1500 $0 Select Drugs & Specialized Services Adult Vision & Fitness - HMO
- Healthy Heart Silver 4500 $0 Select Drugs & Specialized Services - HMO
- Healthy Heart Silver 4500 $0 Select Drugs & Specialized Services Adult Vision & Fitness - HMO
- HSA Eligible Bronze 6000 - HMO
- Low Premium Bronze 9200 $25 Generic Drugs - HMO
- Low Premium Bronze 9200 $25 Generic Drugs Adult Vision & Fitness - HMO
- Low Premium Silver 6000 $3 Generic Drugs - HMO
- Low Premium Silver 6000 $3 Generic Drugs Adult Vision & Fitness - HMO
- Platinum Zero $5 Generic Drugs - HMO
- Platinum Zero $5 Generic Drugs Adult Vision & Fitness - HMO
- Connect Bronze 3800 Indiv Med Deductible - EPO
- Connect Bronze 7000 Indiv Med Deductible Enhanced Diabetes Care - EPO
- Connect Bronze 8550 Indiv Med Deductible - EPO
- Connect Bronze CMS Standard - EPO
- Connect Gold CMS Standard - EPO
- Connect Silver 3000 Indiv Med Deductible - EPO
- Connect Silver 7000 Indiv Med Deductible - EPO
- Connect Silver CMS Standard - EPO
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Medicare Participation & PECOS Enrollment Status
Suzanna Carlton is registered with Medicare and accepts claims assignment, this means the provider accepts the approved amount for the cost of rendered services as full payment. Participating providers may not charge beneficiaries more than the approved amount for their services. Please keep in mind that beneficiaries still have to pay a coinsurance or copayment amount for a visit or service.
Suzanna Carlton is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.
What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.
Is the provider registered in PECOS? Yes
PECOS PAC ID: 9436375839
What is the PECOS Associate Control ID?
A PAC ID is a unique 10-digit number assigned to an individual or organization healthcare provider in PECOS. The PAC ID is used to link together all the provider information, like tax identification numbers and organizational names. A PAC ID can be connected to multiple Enrollment IDs if an individual or organization has enrolled in PECOS more than once.PECOS Enrollment ID: I20160928000140
What is the Provider Enrollment ID?
The Enrollment ID is a unique alphanumeric 15-digit code assigned to each new provider's PECOS enrollment application. The Enrollment ID is used to link together all the provider enrollment information like enrollment type, state, provider specialty, and reassignment of benefits.Accepts Medicare Assignment? Yes
What does it mean "accepts medicare assignment"?
When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes
Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes
Eligible to Order or Refer a Home Health Agency (HHA): Yes
Eligible to Order or Refer Power Mobility Devices: Yes
Areas of Expertise
The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.
Blood test, lipids (cholesterol and triglycerides)
Established patient office or other outpatient visit, 20-29 minutes
Established patient office or other outpatient visit, 30-39 minutes
Established patient office or other outpatient visit, 30-39 minutes
Exercise or drug-induced heart stress test with electrocardiogram (ecg) with supervision by physician
A lipid panel is a blood test that measures fats and fatty substances, such as cholesterol and triglycerides. These substances are used by your body as a source of energy. High levels can lead to health issues, including heart disease.
This service was performed 29 times for 29 patientsThis 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.
This service was performed 13 times for 13 patientsThis 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.
This service was performed 76 times for 75 patientsThis 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.
This service was performed 116 times for 85 patientsAn exercise or drug-induced heart stress test with ECG involves monitoring your heart's activity while it's under stress, either from exercise or medication. A doctor supervises the entire procedure to ensure safety and accuracy in results. This test helps detect heart problems.
This service was performed 121 times for 120 patientsPhysician Visit Costs
The typical physician office visit costs for Medicare beneficiaries in this area are: $20.51 for a new patient copayment and $23.55 for an established patient copayment.
The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.
For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.
The prices below reflect the costs for new and established patients in the 46176 ZIP code area.
New Patients Visit Costs *
The most utilized procedure code for new patients office visits is 99203
- Average New Patient Price $82.04
- Minimum New Patient Price $53.07
- Maximum New Patient Price $161.76
- Average New Patient Copayment $20.51
- Minimum New Patient Copayment $13.26
- Maximum New Patient Copayment $40.44
Established Patients Visit Costs *
The most utilized procedure code for established patients office visits is 99214
- Average Established Patient Price $94.22
- Minimum Established Patient Price $16.93
- Maximum Established Patient Price $132.22
- Average Established Patient Copayment $23.55
- Minimum Established Patient Copayment $4.23
- Maximum Established Patient Copayment $33.05
* The physician office visit costs information is generated by statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.
Find Provider Hospital Affiliations - Privileges
Doctors and physicians must apply for hospital privileges to treat patients at hospitals. Find out if your doctor has privileges to practice at your preferred hospital by using the hospital affiliation information below based on recent medical claims.
Hospital affiliation is identified through self-reporting data, inpatient, outpatient, physician and ancillary service claims linked by the medical claims NPI number and place of service code. Additionally, to further determine provider hospital affiliation the clinician must have provided services to at least three patients on three different dates in the last 12 months. Suzanna Carlton is affiliated with the following medical facilities:
Hospital Name | Address | Phone | Hospital Type | Overall Rating |
---|---|---|---|---|
MAJOR HOSPITAL | 2451 INTELLIPLEX DR SHELBYVILLE, IN 46176 | (317) 392-3211 | Acute Care Hospitals |
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NPI Validation Check Digit Calculation
The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.
Start with the original NPI number, the last digit is the check digit and is not used in the calculation. | |||||||||
1 | 3 | 3 | 6 | 6 | 9 | 5 | 5 | 8 | 4 |
Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
2 | 3 | 6 | 6 | 12 | 9 | 10 | 5 | 16 | |
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
2 + 3 + 6 + 6 + 1 + 2 + 9 + 1 + 0 + 5 + 1 + 6 + 24 = 66 | |||||||||
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
70 - 66 = 4 | 4 |
The NPI number 1336695584 is valid because the calculated check digit 4 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the Same Location
The following 3 providers are registered at the same or nearby location.
ALISON SIMO MSN, RN
Registered Nurse
(Diabetes Educator)
2451 INTELLIPLEX DR STE 215
SHELBYVILLE, IN
ZIP 46176
MRS. DEBRA LYNN MATHIES ANP-BC
Nurse Practitioner
2451 INTELLIPLEX DR STE 215
SHELBYVILLE, IN
ZIP 46176
SHEA ROBERT IDLEWINE FNP-C
Nurse Practitioner
(Family)
2451 INTELLIPLEX DR STE 215
SHELBYVILLE, IN
ZIP 46176
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1336695584, enumerated as an "individual" on August 28, 2016.
The provider is located at 2451 INTELLIPLEX DR STE 215 SHELBYVILLE, IN 46176 and the phone number is (317) 421-1917.
Nurse Practitioner with taxonomy code 363LF0000X and a focus in Family.
The provider might be accepting Accepts: CareSource and Cigna Healthcare. Please consult your insurance carrier or call the provider to verify.
Suzanna Carlton is affiliated with: MAJOR HOSPITAL.