DARRELL J CARMEN M.D.
NPI 1447368626
Urology in Riverdale, GA

Q: What is Darrell Carmen's NPI number?

The NPI number for Darrell Carmen is 1447368626. It was assigned to this individual provider in the NPPES registry on August 28, 2006.

Q: What is Darrell Carmen's specialty?

The primary specialty registered for this NPI is Urology with taxonomy code 208800000X.

Q: When was this NPI record last updated?

The NPPES record for Darrell Carmen was last updated on March 7, 2023. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since August 28, 2006PECOS EnrolledAccepts Medicare Assignment

76.25/100

CMS Quality Rating

33 UPPER RIVERDALE RD SW, SUITE 105, RIVERDALE, GA 30274(770) 991-0020(770) 994-9729 Get Directions Write a Review

NPPES record last updated: March 7, 2023. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Mar 7, 2023, Aug 11, 2020 (2 updates tracked since 2020).

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About Darrell J Carmen M.d. NPPES

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

DARRELL J CARMEN M.D. (NPI 1447368626) is an individual urology provider in Riverdale, Georgia, licensed in Georgia (039749) and active in the NPI registry since August 2006. He is enrolled in Medicare PECOS, is affiliated with Wellstar Kennestone Regional Medical Center, and is a graduate of Louisiana State University School Of Medicine In Shreveport (1990).

NPPES Registry Identity

NPI1447368626

Entity TypeIndividualMale

Primary Taxonomy208800000X

Provider Legal NameDARRELL J CARMENCredential: M.D.

Location Address33 UPPER RIVERDALE RD SW, SUITE 105Riverdale, GA 30274-2626

Mailing Address1930 Brannan RdMcdonough, GA 30253-4310 · (678) 284-4040 · Fax (678) 284-4076

Phone(770) 991-0020

Fax(770) 994-9729

Sole ProprietorNo

Medical School CMSLouisiana State University School Of Medicine In ShreveportGraduated 1990

Enumeration DateAugust 28, 2006

Last NPPES UpdateMarch 7, 20232 updates tracked since enumeration

NPPES CertifiedAugust 11, 2020

✔ NPI 1447368626 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyUrologyAllopathic & Osteopathic Physicians

Taxonomy Code208800000X

License✔ Licensed in GA · 039749

Definition

A urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures.

33 UPPER RIVERDALE RD SW, Riverdale, GA 30274

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Other Identifiers 2

Medicaid000655223AGA

Other340010024GA · Railroad Medicare

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Absolute Total Care, Ambetter Health, Ambetter of Alabama 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

Darrell J Carmen 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 ID9234202268

PECOS Enrollment IDI20101111000722

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 19

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.

Psa (prostate specific antigen) measurement, total 84153

PSA measurement is a simple blood test that checks for a specific protein produced by your body. High levels could indicate a health issue that needs further investigation. It's often used to monitor general wellness and is part of routine health screening.

393 services283 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.

374 services266 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.

188 services153 patients

Automated urinalysis test 81003

An automated urinalysis test is a routine examination that checks your urine for various substances. It can help identify potential health issues such as kidney problems or diabetes. The test uses a machine to analyze a small urine sample, providing quick and accurate results.

174 services140 patients

Complex measurement of pressure of urine flow in bladder with voiding pressure studies 51728

This procedure measures the pressure in your bladder as it fills and empties. It helps to understand how well your bladder is functioning. Sensors record pressure levels during these processes, providing valuable data for your doctor.

51 services51 patients

Injection of drug or substance under skin or into muscle 96372

This procedure involves administering medication directly under the skin or into a muscle. A small needle is used to inject the drug, allowing it to be absorbed quickly into the bloodstream. It's a common method for delivering a variety of medications.

51 services12 patients

Non-needle measurement and recording of electrical activity of muscles at bladder and bowel openings 51784

This procedure involves the use of non-invasive devices to record the electrical activity of muscles at specific body openings. It's helpful in understanding muscle function and can assist in diagnosing certain conditions.

50 services50 patients

Insertion of device into abdomen with pressure and urine flow rate study 51797

This procedure involves placing a small device into your abdomen to monitor pressure and urine flow rates. It helps in understanding how well your body is processing and eliminating liquid waste. It's a safe procedure, typically performed under local anesthesia.

50 services50 patients

Electronic assessment of bladder emptying 51741

Electronic assessment of bladder emptying is a non-invasive test that measures how well your bladder functions. It uses ultrasound technology to create images of your bladder before and after you use the restroom, helping to identify any issues with bladder emptying.

37 services36 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.

31 services31 patients

Urinalysis, manual test 81002

A urinalysis is a simple, non-invasive test that checks the urine for various elements such as sugar, protein, and signs of infection. It can help detect many common conditions, including kidney disease and diabetes. The manual test involves a lab technician examining a urine sample.

30 services30 patients

Diagnostic exam of bladder and urethra using an endoscope 52000

This procedure involves using a thin, flexible tube with a light, called an endoscope, to examine the bladder and urethra. It helps in identifying any abnormalities or issues that may be causing discomfort or other symptoms.

27 services27 patients

Testosterone (hormone) level, total 84403

A total testosterone level test measures the amount of a key hormone in your body. This hormone influences various body functions such as muscle mass, energy levels, and mood. The test involves a simple blood draw, and results help monitor health conditions.

26 services26 patients

Injection, garamycin, gentamicin, up to 80 mg J1580

This procedure involves administering an injection of Gentamicin, also known as Garamycin, up to a dose of 80 mg. Gentamicin is an antibiotic used to treat a wide variety of bacterial infections. It works by stopping the growth of bacteria.

20 services18 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.

15 services15 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.

15 services13 patients

Biopsy of prostate gland 55700

A biopsy of the prostate gland is a procedure where a small sample of tissue is taken from your body's internal gland, located near the bladder, for testing. This helps in diagnosing potential health issues. It's usually done with a fine needle and imaging technology for accuracy.

14 services14 patients

Simple bladder irrigation and/or instillation 51700

Bladder irrigation and/or instillation is a process where a sterile solution is introduced into the bladder to cleanse it or deliver medication. This procedure helps manage certain bladder conditions, ensuring optimal bladder health.

13 services12 patients

Insertion of tube into ureter using an endoscope through bladder area 52005

This procedure involves the use of a thin, flexible tool called an endoscope. It's inserted through the body's natural pathways to reach the area where urine is transported. A small tube is then placed in this area to help with urine flow or to remove blockages.

12 services12 patients

Hospital Affiliations CMS Care Compare 5

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

Wellstar Kennestone Regional Medical Center

Acute Care Hospitals · Marietta, GA

4/5 CMS rating

OwnershipGovernment - Hospital District or Authority

CMS Certification Number110035

Location677 Church StreetMarietta, GA 30060 · Cobb County

Emergency services Birthing friendly

Northside Hospital

Acute Care Hospitals · Atlanta, GA

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number110161

Location1000 Johnson Ferry Road, NEAtlanta, GA 30342 · Fulton County

Birthing friendly

Southern Regional Medical Center

Acute Care Hospitals · Riverdale, GA

1/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number110165

Location11 Upper Riverdale Road, SWRiverdale, GA 30274 · Clayton County

Emergency services Birthing friendly

Piedmont Henry Hospital

Acute Care Hospitals · Stockbridge, GA

2/5 CMS rating

OwnershipGovernment - Hospital District or Authority

CMS Certification Number110191

Location1133 Eagle's Landing ParkwayStockbridge, GA 30281 · Henry County

Emergency services Birthing friendly

Piedmont Fayette Hospital

Acute Care Hospitals · Fayetteville, GA

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number110215

Location1255 Highway 54 WestFayetteville, GA 30214 · Fayette County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 30274 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

$130.64 typical visit price

range $56.84 – $172.43

Typical copayment $32.66 (range $14.21 – $43.10)

Most-billed visit code 99204

Established Patient

$70.85 typical visit price

range $18.22 – $140.40

Typical copayment $17.71 (range $4.55 – $35.10)

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.

76.25/100

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

Scored as part of a group practice

Quality

54.88

Promoting Interoperability

Improvement Activities

Cost

68.46

Reported Quality Measures

Documentation of Current Medications in the Medical Record

Percentage of visits for patients aged 18 years and older for which the eligible professional or eligible clinician attests to documenting a list of current medications using all immediate resources available on the date of the encounter.

95%3,068 patients4/55-star benchmark: 100%

e-Prescribing

At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology.

60%589 patients3/55-star benchmark: 100%

Health Information Exchange

The MIPS eligible clinician that transitions or refers their patient to another setting of care or health care clinician (1) uses CEHRT to create a summary of care record; and (2) electronically transmits such summary to a receiving health care clinician for…

41%431 patients2/55-star benchmark: 98%

Medication Reconciliation

The MIPS eligible clinician performs medication reconciliation for at least one transition of care in which the patient is transitioned into the care of the MIPS eligible clinician.

96%189 patients4/55-star benchmark: 100%

Patient-Specific Education

The MIPS eligible clinician must use clinically relevant information from CEHRT to identify patient-specific educational resources and provide access to those materials to at least one unique patient seen by the MIPS eligible clinician.

81%712 patients4/55-star benchmark: 100%

Pneumococcal Vaccination Status for Older Adults

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

24%927 patients2/55-star benchmark: 90%

Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan

Percentage of patients aged 18 years and older with a BMI documented during the current encounter or during the previous twelve months AND with a BMI outside of normal parameters, a follow-up plan is documented during the encounter or during the previous…

92%1,675 patients4/55-star benchmark: 97%

Preventive Care and Screening: Influenza Immunization

Percentage of patients aged 6 months and older seen for a visit between October 1 and March 31 who received an influenza immunization OR who reported previous receipt of an influenza immunization

28%704 patients2/55-star benchmark: 88%

Provide Patient Access

At least one patient seen by the MIPS eligible clinician during the performance period is provided timely access to view online, download, and transmit to a third party their health information subject to the MIPS eligible clinician's discretion to withhold…

71%727 patients3/55-star benchmark: 100%

Secure Messaging

For at least one unique patient seen by the MIPS eligible clinician during the performance period, a secure message was sent using the electronic messaging function of CEHRT to the patient (or the patient-authorized representative), or in response to a secure…

61%727 patients4/55-star benchmark: 79%

Urinary Incontinence: Assessment of Presence or Absence of Urinary Incontinence in Women Aged 65 Years and Older

Percentage of female patients aged 65 years and older who were assessed for the presence or absence of urinary incontinence within 12 months

98%298 patients4/55-star benchmark: 100%

Use of High-Risk Medications in the Elderly

Percentage of patients 65 years of age and older who were ordered high-risk medications. Two rates are submitted. 1) Percentage of patients who were ordered at least one high-risk medication.

Lower rates are better for this measure.

Patients 2+: 0% · 927 patients

1%927 patients4/55-star benchmark: 100%

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 2

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

Intermittent urinary catheter; straight tip, with or without coating (teflon, silicone, silicone elastomer, or hydrophilic, etc.), each A4351

DME-Orthotic Devices · category DF008N

6 suppliers32 claims6,090 services$1.70 avg. paid by Medicare

Lubricant, per ounce A4402

DME-Orthotic Devices · category DF010N

2 suppliers21 claims178 services$1.33 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.

GEORGIA CANCER SPECIALISTS I, PC

Internal Medicine (Hematology & Oncology)

33 UPPER RIVERDALE RD SW, SUITE 121
RIVERDALE, GA 30274

Clayton County (770) 997-1253

DR. KEVIN STEWART FREEMAN M.D.

Specialist

33 UPPER RIVERDALE RD SW, SUITE 114
RIVERDALE, GA 30274

Clayton County (770) 991-1624

GEORGIA HEART ASSOCIATES, PC

Internal Medicine (Cardiovascular Disease)

33 UPPER RIVERDALE RD SW, SUITE 118
RIVERDALE, GA 30274

Clayton County (770) 991-9166

MATTHEW EDWIN DAVIS M.D.

Otolaryngology

33 UPPER RIVERDALE RD SW, SUITE 117
RIVERDALE, GA 30274

Clayton County (770) 991-1170

GLENN S SHEAR MDPC

Specialist

33 UPPER RIVERDALE RD SW, SUITE 114
RIVERDALE, GA 30274

Clayton County (770) 991-1624

ROBIN PASQUALE ALVERSON MMS, CCC-A

Audiologist

33 UPPER RIVERDALE RD SW, SUITE 117
RIVERDALE, GA 30274

Clayton County (770) 991-1170

MINIMALLY INVASIVE NEUROSPINE AND PAIN INSTITUTE, PC

Clinic/Center (Ambulatory Surgical)

33 UPPER RIVERDALE RD SW, #25
RIVERDALE, GA 30274

Clayton County (770) 997-0600

RICHARD A. STAPPENBECK, M.D., P.C.

Psychiatry & Neurology (Neurology)

33 UPPER RIVERDALE RD SW, SUITE 111
RIVERDALE, GA 30274

Clayton County (770) 997-4018

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 Darrell Carmen's NPI number?

The NPI number for Darrell Carmen is 1447368626. It was assigned to this individual provider in the NPPES registry on August 28, 2006.

Where is Darrell Carmen located?

Darrell Carmen practices at 33 Upper Riverdale Rd SW Suite 105, Riverdale, GA 30274. The listed phone number is (770) 991-0020.

What is Darrell Carmen's specialty?

The primary specialty registered for this NPI is Urology with taxonomy code 208800000X.

Is Darrell Carmen enrolled in Medicare?

Yes. Darrell Carmen 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 Darrell Carmen accept?

Health plans from Ambetter Health, Ambetter from Absolute Total Care, Ambetter of Alabama, Ambetter of North Carolina and Ambetter of Tennessee list Darrell Carmen 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 Darrell Carmen affiliated with any hospitals?

According to CMS data, Darrell Carmen is affiliated with Wellstar Kennestone Regional Medical Center, Northside Hospital, Southern Regional Medical Center, Piedmont Henry Hospital and Piedmont Fayette Hospital.

When was this NPI record last updated?

The NPPES record for Darrell Carmen was last updated on March 7, 2023. NPI Profile syncs with the weekly NPPES data releases published by CMS.