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JOHN M CARL III MD
NPI 1437193323
Surgery in Charlottesville, VA

Active since June 15, 2006PECOS Enrolled
95.11/100
CMS Quality Rating
500 MARTHA JEFFERSON DRIVE, 5TH FLOOR, CHARLOTTESVILLE, VA 22911(434) 654-5260(434) 654-5262 Get Directions Write a Review

NPPES record last updated: March 13, 2018. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About John M Carl Iii Md NPPES

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

JOHN M CARL III MD (NPI 1437193323) is an individual surgery provider in Charlottesville, Virginia, licensed in Virginia (0101227465) and active in the NPI registry since June 2006. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1437193323
Entity TypeIndividualMale
Primary Taxonomy208600000X
Provider Legal NameJOHN M CARL IIICredential: MD
Location Address500 MARTHA JEFFERSON DRIVE, 5TH FLOORCharlottesville, VA 22911-4668
Mailing AddressPo Box 79777Baltimore, MD 21279-0777 · (434) 654-7794 · Fax (434) 654-5261
Phone(434) 654-5260
Fax(434) 654-5262
Sole ProprietorNo
Enumeration DateJune 15, 2006
Last NPPES UpdateMarch 13, 2018
✔ NPI 1437193323 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySurgeryAllopathic & Osteopathic Physicians
Taxonomy Code208600000X
License✔ Licensed in VA · 0101227465
Definition
A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery.
500 MARTHA JEFFERSON DRIVE, Charlottesville, VA 22911
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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

John M Carl Iii Md 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 Reassignment

Medicare enrollment records show John Carl reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Martha Jefferson Medical Group LLC
0.1 mi
Family Medicine
590 PETER JEFFERSON PKWY STE 300
Charlottesville, VA 22911
  • Reassigned Medicare billing, Virginia enrollment
  • 307 clinicians in this Medicare group
NPI 1275720559 (434) 654-7340

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 10

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.

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.
43 services43 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.
34 services34 patients
Subsequent hospital care with straightforward or low level of medical decision making, per day, if using time, at least 25 minutes 99231
Follow-up hospital inpatient care is a daily service where a healthcare professional checks on your health progress during your hospital stay. Each session typically lasts 15 minutes, involving updates on your condition and adjustments to your treatment plan, if necessary.
32 services14 patients
Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more 99212
This is a routine check-up for patients who have previously seen the doctor. During this 10-19 minute visit, the doctor will review your health status, discuss any concerns, and manage ongoing treatments or medications. It's a chance to ensure your health is on track.
20 services12 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.
20 services19 patients
Removal of gallbladder using an endoscope 47562
This procedure, known as endoscopic gallbladder removal, involves a surgeon using a special tool called an endoscope to remove your gallbladder through small incisions. It's typically done to treat gallstones and related complications. It's a less invasive method, often leading to quicker recovery.
18 services18 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 22911 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
$86.88 typical visit price
range $56.19 – $170.30
Typical copayment $21.72 (range $14.04 – $42.57)
Most-billed visit code 99203
Established Patient
$70.08 typical visit price
range $18.07 – $138.91
Typical copayment $17.52 (range $4.51 – $34.72)
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.

95.11/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored through an Alternative Payment Model
Quality86.31
Promoting Interoperability100
Improvement Activities40

Other Providers at the Same Location NPPES 8

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MR. NORMAND ROLAND DUBE FNP
Nurse Practitioner (Family)
500 MARTHA JEFFERSON DRIVE, INPATIENT SERVICES
CHARLOTTESVILLE, VA 22911
Albemarle County (434) 654-7580
CENTRAL VIRGINIA RADIATION ONCOLOGISTS P C
Radiology (Radiation Oncology)
500 MARTHA JEFFERSON DRIVE
CHARLOTTESVILLE, VA 22911
Albemarle County (434) 982-8125
MS. GENEVIEVE F HARWAY FNP
Nurse Practitioner (Family)
500 MARTHA JEFFERSON DRIVE, 5TH FLOOR
CHARLOTTESVILLE, VA 22911
Albemarle County (434) 654-5260
MARTHA JEFFERSON HOSPITAL
Internal Medicine (Cardiovascular Disease)
500 MARTHA JEFFERSON DRIVE, MB# G231
CHARLOTTESVILLE, VA 22911
Albemarle County (434) 654-7195
CHRISTEN JOYCE DUXBURY
Student in an Organized Health Care Education/Training Program
500 MARTHA JEFFERSON DRIVE, WENDEL 1 C/O CHRISTEN DUXBURY
CHARLOTTESVILLE, VA 22911
Albemarle County (434) 825-4891
GORDON L MORRIS MD
Internal Medicine (Hematology & Oncology)
500 MARTHA JEFFERSON DRIVE, PHILLIPS CANCER CENTER
CHARLOTTESVILLE, VA 22911
Albemarle County (434) 654-8390
DR. CYNTHIA SPAULDING M.D.
Radiology (Radiation Oncology)
500 MARTHA JEFFERSON DRIVE
CHARLOTTESVILLE, VA 22911
Albemarle County (434) 654-8125
MARTHA JEFFERSON HOSPTIAL
Dietitian, Registered
500 MARTHA JEFFERSON DRIVE, COMMUNITY SERVICES
CHARLOTTESVILLE, VA 22911
Albemarle County (434) 654-4407

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 Carl's NPI number?

The NPI number for John Carl is 1437193323. It was assigned to this individual provider in the NPPES registry on June 15, 2006.

Where is John Carl located?

John Carl practices at 500 Martha Jefferson Drive 5th Floor, Charlottesville, VA 22911. The listed phone number is (434) 654-5260.

What is John Carl's specialty?

The primary specialty registered for this NPI is Surgery with taxonomy code 208600000X.

Is John Carl enrolled in Medicare?

Yes. John Carl is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for John Carl's services?

According to the CMS Revalidation Reassignment List (October 2026 release), John Carl reassigns Medicare benefits to Martha Jefferson Medical Group LLC (Charlottesville, VA). The 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 John Carl's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for John Carl was last updated on March 13, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 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.