DR. CARLTON GREGORY CAUTHEN M.D.
NPI 1346258746
Internal Medicine - Pulmonary Disease in Columbia, SC

Q: What is Carlton Cauthen's NPI number?

The NPI number for Carlton Cauthen is 1346258746. It was assigned to this individual provider in the NPPES registry on August 3, 2006.

Q: What is Carlton Cauthen'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 Carlton Cauthen was last updated on June 24, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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 August 03, 2006PECOS EnrolledAccepts Medicare Assignment

83.03/100

CMS Quality Rating

3016 LONGTOWN COMMONS DR, COLUMBIA, SC 29229(803) 936-8900(803) 935-8667 Get Directions Write a Review

NPPES record last updated: June 24, 2022. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Oct 15, 2020, Sep 29, 2020, Apr 27, 2018 (3 updates tracked since 2018).

On this page

About Dr. Carlton Gregory Cauthen M.d. NPPES

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

DR. CARLTON GREGORY CAUTHEN M.D. (NPI 1346258746) is an individual pulmonary disease provider in Columbia, South Carolina, licensed in South Carolina (30705) and active in the NPI registry since August 2006. He is enrolled in Medicare PECOS, is affiliated with Musc Medical Center, and is a graduate of University Of South Carolina School Of Medicine (2002).

NPPES Registry Identity

NPI1346258746

Entity TypeIndividualMale

Primary Taxonomy207RP1001X

Provider Legal NameDR. CARLTON GREGORY CAUTHENCredential: M.D.

Location Address3016 LONGTOWN COMMONS DRColumbia, SC 29229-7861

Mailing AddressPo Box 6069West Columbia, SC 29171-6069

Phone(803) 936-8900

Fax(803) 935-8667

Sole ProprietorYes

Medical School CMSUniversity Of South Carolina School Of MedicineGraduated 2002

Enumeration DateAugust 3, 2006

Last NPPES UpdateJune 24, 20223 updates tracked since enumeration

NPPES CertifiedJune 24, 2022

✔ NPI 1346258746 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyInternal Medicine · Pulmonary DiseaseAllopathic & Osteopathic Physicians

Taxonomy Code207RP1001X

Licenses✔ Licensed in SC · 30705✔ Licensed in SC · TL30705✔ Licensed in NC · 2006-00014

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.

Also ListedInternal Medicine · Critical Care MedicineTaxonomy 207RC0200X · License 30705 (SC)

3016 LONGTOWN COMMONS DR, Columbia, SC 29229

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Other Identifiers 1

Medicaid1346258746SC

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Absolute Total Care, Ambetter of North Carolina, BlueCross BlueShield of South Carolina 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

Dr. Carlton Gregory Cauthen 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 ID8921108572

PECOS Enrollment IDI20080707000040

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 20

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.

814 services522 patients

Test to measure rate of airflow 94375

This test, known as spirometry, measures how much air you can breathe in and out, and how quickly you can do so. It helps assess your lung function and can be used to diagnose or monitor conditions like asthma or COPD.

782 services500 patients

Test for exercise-induced lung stress 94618

An exercise-induced lung stress test assesses how your lungs respond to physical activity. During the test, you'll exercise on a treadmill or stationary bike while your heart rate, breathing, blood pressure, and oxygen levels are monitored. This helps identify any abnormal lung responses to exercise.

283 services241 patients

Test to examine how well the lungs exchange gases 94729

This is a test called a pulmonary function test, which helps understand the efficiency of your lungs. It measures how much air your lungs can hold, how quickly you can move air in and out of your lungs, and how well your lungs put oxygen into and remove carbon dioxide from your blood.

255 services235 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.

240 services240 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.

235 services219 patients

Test to determine lung volumes using sensors 94726

This test, called spirometry, measures lung capacity using sensors. You breathe into a mouthpiece attached to a device that records the amount and rate of air you inhale and exhale. It helps diagnose and monitor lung conditions.

214 services214 patients

Sleep study including heart rate, breathing, and sleep time 95800

A sleep study monitors your sleep patterns to evaluate your sleep quality. It records your heart rate, breathing, and actual sleep time. This information helps identify any sleep disorders, ensuring you get the rest you need for optimal health.

126 services126 patients

New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203

This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.

83 services83 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.

73 services73 patients

X-ray of chest, 2 views 71046

A chest X-ray, 2 views, is a quick, painless test that creates pictures of the structures inside your chest, such as your heart, lungs, and blood vessels. Two different angles are used to get a comprehensive view. This helps in diagnosing conditions like pneumonia, heart problems, or lung cancer.

58 services58 patients

Sleep study in sleep lab (6 years or older) 95810

A sleep study in a sleep lab is a non-invasive overnight test that monitors your body while you sleep. It helps doctors understand your sleep patterns and identify any issues like sleep apnea or insomnia. You'll be connected to equipment that tracks your heart rate, brain waves, breathing, and movements.

58 services58 patients

Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes 99222

Initial hospital inpatient care is a service where a healthcare provider spends about 50 minutes per day overseeing your care while you're admitted in the hospital. This includes reviewing your health status, planning your treatment, and ensuring your safety and comfort.

34 services34 patients

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes 99232

Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.

34 services27 patients

Counseling visit to discuss need for lung cancer screening using low dose ct scan (ldct) (service is for eligibility determination and shared decision making) G0296

This visit involves discussing the necessity of a lung cancer screening using a low dose CT scan. It's a chance to determine if you're eligible for the test and to make an informed decision about proceeding. The scan can potentially detect lung cancer early, improving treatment outcomes.

34 services32 patients

Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more 99215

This service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.

33 services29 patients

Ct scan of chest without contrast 71250

A CT scan of the chest without contrast is a non-invasive imaging procedure. It uses special X-ray equipment to produce detailed images of your chest area, including your lungs and heart. It can help diagnose conditions such as lung diseases or heart disorders. It doesn't involve any dyes or contrast agents.

18 services18 patients

Insertion of needle into vein for collection of blood sample 36415

This procedure involves inserting a small needle into a vein, typically in your arm, to collect a blood sample. It's a quick and simple process to help diagnose or monitor health conditions. You may feel a small prick, but discomfort is minimal.

15 services15 patients

Irrigation and suction of lung airways to obtain cells using an endoscope 31624

This is a procedure where a thin, flexible tube called an endoscope is inserted through your mouth into the lungs. A small amount of saline is then introduced to wash the airways. The fluid, along with cells from the lung, is suctioned back for analysis.

14 services14 patients

Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes 99223

Initial hospital inpatient care per day, typically 70 minutes, refers to the daily medical service provided to patients admitted to the hospital. This includes a comprehensive evaluation, diagnosis, treatment plan, and monitoring of your health condition. It ensures your well-being during your hospital stay.

11 services11 patients

Hospital Affiliations CMS Care Compare 5

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

Musc Medical Center

Acute Care Hospitals · Charleston, SC

2/5 CMS rating

OwnershipGovernment - Hospital District or Authority

CMS Certification Number420004

Location169 Ashley AveCharleston, SC 29425 · Charleston County

Emergency services Birthing friendly

Musc Health Chester Medical Center

Acute Care Hospitals · Chester, SC

OwnershipProprietary

CMS Certification Number420019

Location1 Medical Park DriveChester, SC 29706 · Chester County

Emergency services

Musc Health Columbia Medical Center Downtown

Acute Care Hospitals · Columbia, SC

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number420026

Location2435 Forest DriveColumbia, SC 29204 · Richland County

Emergency services

Kershawhealth

Acute Care Hospitals · Camden, SC

3/5 CMS rating

OwnershipProprietary

CMS Certification Number420048

Location1315 Roberts StreetCamden, SC 29020 · Kershaw County

Emergency services Birthing friendly

Lexington Medical Center

Acute Care Hospitals · West Columbia, SC

3/5 CMS rating

OwnershipGovernment - Hospital District or Authority

CMS Certification Number420073

Location2720 Sunset BlvdWest Columbia, SC 29169 · Lexington County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 29229 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

$124.04 typical visit price

range $53.57 – $163.84

Typical copayment $31.01 (range $13.39 – $40.96)

Most-billed visit code 99204

Established Patient

$95.12 typical visit price

range $16.96 – $133.52

Typical copayment $23.78 (range $4.24 – $33.38)

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.

83.03/100

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

Scored as part of a group practice

Quality

80.45

Promoting Interoperability

Improvement Activities

Cost

72.17

Referred Medical Equipment & Supplies CMS DME claims 42

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

Supplies for maintenance of non-insulin drug infusion catheter, per week (list drugs separately) A4221

DME-Other DME · category DE017N

2 suppliers23 claims92 services$17.97 avg. paid by Medicare

Infusion supplies for external drug infusion pump, per cassette or bag (list drugs separately) A4222

DME-Medical/Surgical Supplies · category DA000N

2 suppliers11 claims330 services$37.84 avg. paid by Medicare

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

DME-Other DME · category DE001N

23 suppliers684 claims684 services$33.52 avg. paid by Medicare

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

DME-Other DME · category DE000N

7 suppliers39 claims78 services$1.23 avg. paid by Medicare

Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable A7005

DME-Other DME · category DE000N

7 suppliers23 claims23 services$12.27 avg. paid by Medicare

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

DME-Other DME · category DE001N

19 suppliers417 claims417 services$74.67 avg. paid by Medicare

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

DME-Other DME · category DE001N

19 suppliers407 claims1,125 services$27.99 avg. paid by Medicare

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

DME-Other DME · category DE001N

14 suppliers182 claims1,017 services$15.70 avg. paid by Medicare

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

DME-Other DME · category DE001N

20 suppliers158 claims904 services$12.80 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

23 suppliers355 claims356 services$44.98 avg. paid by Medicare

Headgear used with positive airway pressure device A7035

DME-Other DME · category DE001N

27 suppliers411 claims411 services$16.04 avg. paid by Medicare

Chinstrap used with positive airway pressure device A7036

DME-Other DME · category DE001N

6 suppliers22 claims22 services$8.78 avg. paid by Medicare

Tubing used with positive airway pressure device A7037

DME-Other DME · category DE001N

14 suppliers76 claims76 services$9.79 avg. paid by Medicare

Filter, disposable, used with positive airway pressure device A7038

DME-Other DME · category DE001N

29 suppliers705 claims3,998 services$1.77 avg. paid by Medicare

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

DME-Other DME · category DE001N

7 suppliers11 claims11 services$4.85 avg. paid by Medicare

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

DME-Other DME · category DE001N

25 suppliers308 claims308 services$12.04 avg. paid by Medicare

Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing E0431

DME-Oxygen and Supplies · category DC000N

15 suppliers358 claims371 services$15.05 avg. paid by Medicare

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

DME-Oxygen and Supplies · category DC000N

5 suppliers39 claims39 services$38.31 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 suppliers95 claims95 services$651.94 avg. paid by Medicare

Respiratory assist device, bi-level pressure capability, without backup rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device) E0470

DME-Other DME · category DE001N

6 suppliers130 claims131 services$74.48 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

2 suppliers16 claims16 services$171.49 avg. paid by Medicare

High frequency chest wall oscillation system, with full anterior and/or posterior thoracic region receiving simultaneous external oscillation, includes all accessories and supplies, each E0483

DME-Other DME · category DE000N

3 suppliers38 claims38 services$825.53 avg. paid by Medicare

Humidifier, heated, used with positive airway pressure device E0562

DME-Other DME · category DE001N

7 suppliers51 claims51 services$120.40 avg. paid by Medicare

Humidifier, heated, used with positive airway pressure device E0562

DME-Other DME · category DE001N

4 suppliers42 claims49 services$10.91 avg. paid by Medicare

Nebulizer, with compressor E0570

DME-Other DME · category DE000N

10 suppliers170 claims170 services$3.71 avg. paid by Medicare

Ultrasonic/electronic aerosol generator with small volume nebulizer E0574

DME-Other DME · category DE000N

1 supplier12 claims12 services$30.47 avg. paid by Medicare

Continuous positive airway pressure (cpap) device E0601

DME-Other DME · category DE001N

14 suppliers468 claims469 services$28.09 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

21 suppliers681 claims694 services$67.01 avg. paid by Medicare

Portable oxygen concentrator, rental E1392

DME-Oxygen and Supplies · category DC002N

8 suppliers158 claims158 services$32.99 avg. paid by Medicare

Injection, epoprostenol, 0.5 mg J1325

Treatment-Injections and Infusions (nononcologic) · category RI026N

2 suppliers13 claims3,804 services$12.69 avg. paid by Medicare

Injection, immune globulin (hizentra), 100 mg J1559

Treatment-Injections and Infusions (nononcologic) · category RI008N

1 supplier12 claims3,840 services$9.50 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

17 suppliers100 claims6,282 services$4.75 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

20 suppliers116 claims23,165 services$0.03 avg. paid by Medicare

Levalbuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 0.5 mg J7614

DME-Drugs Administered Through DME · category DG006N

5 suppliers23 claims3,037 services$0.05 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

4 suppliers31 claims4,110 services$0.09 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

22 suppliers161 claims9,627 services$0.76 avg. paid by Medicare

Revefenacin inhalation solution, fda-approved final product, non-compounded, administered through dme, 1 microgram J7677

DME-Drugs Administered Through DME · category DG006N

4 suppliers36 claims189,000 services$0.15 avg. paid by Medicare

Treprostinil, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose form, 1.74 mg J7686

DME-Drugs Administered Through DME · category DG004N

2 suppliers31 claims868 services$549.64 avg. paid by Medicare

Infusion pump used for uninterrupted parenteral administration of medication, (e.g., epoprostenol or treprostinol) K0455

DME-Other DME · category DE000N

2 suppliers11 claims11 services$239.22 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

2 suppliers17 claims17 services$34.06 avg. paid by Medicare

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

DME-Other DME · category DE000N

32 suppliers301 claims301 services$25.00 avg. paid by Medicare

Pharmacy dispensing fee for inhalation drug(s); per 90 days Q0514

DME-Other DME · category DE000N

6 suppliers11 claims11 services$49.74 avg. paid by Medicare

Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

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 Carlton Cauthen's NPI number?

The NPI number for Carlton Cauthen is 1346258746. It was assigned to this individual provider in the NPPES registry on August 3, 2006.

Where is Carlton Cauthen located?

Carlton Cauthen practices at 3016 Longtown Commons Dr, Columbia, SC 29229. The listed phone number is (803) 936-8900.

What is Carlton Cauthen's specialty?

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

Is Carlton Cauthen enrolled in Medicare?

Yes. Carlton Cauthen 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 Carlton Cauthen accept?

Health plans from Ambetter from Absolute Total Care, Ambetter of North Carolina, BlueCross BlueShield of South Carolina and Molina Healthcare list Carlton Cauthen 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 Carlton Cauthen affiliated with any hospitals?

According to CMS data, Carlton Cauthen is affiliated with Musc Medical Center, Musc Health Chester Medical Center, Musc Health Columbia Medical Center Downtown, Kershawhealth and Lexington Medical Center.

When was this NPI record last updated?

The NPPES record for Carlton Cauthen was last updated on June 24, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.