MANUEL F CARCELEN MD
NPI 1538124607
Internal Medicine - Pulmonary Disease in Birmingham, AL

Q: What is Manuel Carcelen's NPI number?

The NPI number for Manuel Carcelen is 1538124607. It was assigned to this individual provider in the NPPES registry on April 20, 2006.

Q: What is Manuel 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 Manuel 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 20, 2006PECOS EnrolledAccepts Medicare Assignment

96.24/100

CMS Quality Rating

619 19TH ST S, BIRMINGHAM, AL 35249(205) 934-4011(205) 297-9411 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 Manuel F Carcelen Md NPPES

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

MANUEL F CARCELEN MD (NPI 1538124607) is an individual pulmonary disease provider in Birmingham, Alabama, licensed in Alabama (13862) and active in the NPI registry since April 2006. He is enrolled in Medicare PECOS, maintains a secondary practice location in Birmingham, and is a graduate of University Of Alabama School Of Medicine (1988).

NPPES Registry Identity

NPI1538124607

Entity TypeIndividualMale

Primary Taxonomy207RP1001X

Provider Legal NameMANUEL F CARCELENCredential: MD

Location Address619 19TH ST SBirmingham, AL 35249-8718

Mailing AddressPo Box 55310Birmingham, AL 35255-5310 · (205) 731-9701 · Fax (205) 297-9411

Phone(205) 934-4011

Fax(205) 297-9411

Sole ProprietorNo

Medical School CMSUniversity Of Alabama School Of MedicineGraduated 1988

Enumeration DateApril 20, 2006

Last NPPES UpdateFebruary 1, 2024

NPPES CertifiedJune 28, 2023

✔ NPI 1538124607 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 · 13862

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 Location 1

Location 12000 6th Ave SBirmingham, AL 35233-2110 · Phone (205) 996-5864 · Fax (205) 801-8105

Other Identifiers 1

Medicaid051551754AL

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Magnolia Health, 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

Manuel F 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 ID2466584883

PECOS Enrollment IDI20100721000508

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 6

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.

183 services103 patients

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

59 services34 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.

27 services27 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.

21 services17 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 services16 patients

New patient office or other outpatient visit with a high level of medical decision making, if using time, 60 minutes or more 99205

This is a first-time patient visit where a healthcare professional spends 60-74 minutes with you. It involves a comprehensive evaluation, including your medical history and current health condition. They'll also advise on preventive health measures and formulate a treatment plan if needed.

11 services11 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

78%494 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 13

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

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

DME-Other DME · category DE000N

4 suppliers11 claims20 services$1.45 avg. paid by Medicare

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

DME-Other DME · category DE001N

5 suppliers11 claims11 services$82.39 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

3 suppliers27 claims27 services$15.98 avg. paid by Medicare

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

DME-Oxygen and Supplies · category DC000N

2 suppliers12 claims14 services$40.64 avg. paid by Medicare

Home ventilator, any type, used with invasive interface, (e.g., tracheostomy tube) E0465

DME-Other DME · category DE005N

1 supplier12 claims12 services$784.18 avg. paid by Medicare

Nebulizer, with compressor E0570

DME-Other DME · category DE000N

3 suppliers23 claims23 services$5.37 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)