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RICHARD F CARUSO MD
NPI 1548252265
Internal Medicine - Gastroenterology in Lewes, DE

Active since August 18, 2005PECOS EnrolledAccepts Medicare Assignment
75/100
CMS Quality Rating
1309 SAVANNAH RD, STE B, LEWES, DE 19958(302) 645-6698(302) 645-4505 Get Directions Write a Review

NPPES record last updated: March 31, 2020. Verified against the NPPES registry weekly; last sync: September 13, 2026.

About Richard F Caruso Md NPPES

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

RICHARD F CARUSO MD (NPI 1548252265) is an individual gastroenterology provider in Lewes, Delaware, licensed in Delaware (C1-0004112) and active in the NPI registry since August 2005. He is enrolled in Medicare PECOS and is a graduate of Jefferson Medical College Of Thomas Jefferson University (1988).

NPPES Registry Identity

NPI1548252265
Entity TypeIndividualMale
Primary Taxonomy207RG0100X
Provider Legal NameRICHARD F CARUSOCredential: MD
Location Address1309 SAVANNAH RD, STE BLewes, DE 19958-1514
Mailing AddressPo Box 472Lewes, DE 19958-0422 · (302) 645-6698 · Fax (302) 645-4505
Phone(302) 645-6698
Fax(302) 645-4505
Sole ProprietorNo
Medical School CMSJefferson Medical College Of Thomas Jefferson UniversityGraduated 1988
Enumeration DateAugust 18, 2005
Last NPPES UpdateMarch 31, 2020
NPPES CertifiedMarch 31, 2020
✔ NPI 1548252265 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · GastroenterologyAllopathic & Osteopathic Physicians
Taxonomy Code207RG0100X
License✔ Licensed in DE · C1-0004112
Definition
An internist who specializes in diagnosis and treatment of diseases of the digestive organs including the stomach, bowels, liver and gallbladder. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using endoscopes to visualize internal organs.
1309 SAVANNAH RD, Lewes, DE 19958
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Other Identifiers 1

Medicaid0000494801DE

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Highmark Blue Cross Blue Shield Delaware.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

Richard F Caruso 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 ID8628000783
PECOS Enrollment IDI20050909000183
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 11

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.

Biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope 43239
This procedure involves using a thin, flexible tube with a light and camera, known as an endoscope, to examine the esophagus, stomach, and upper part of the small intestine. Small tissue samples are taken for further examination to help diagnose various conditions.
389 services379 patients
Removal of polyps or growths of large bowel using an endoscope with mechanical snare 45385
This procedure involves using a thin, flexible tube called an endoscope to examine the large bowel. If any abnormal growths or polyps are found, a tool called a mechanical snare is used to remove them. This is a common method to prevent potential health issues.
333 services331 patients
Colorectal cancer screening; colonoscopy on individual at high risk G0105
Colorectal cancer screening, specifically a colonoscopy, is a preventive measure for those at high risk. A thin, flexible tube with a camera inspects the colon to spot any abnormal growths. This test helps detect potential issues early, enhancing the effectiveness of treatment.
250 services250 patients
Colorectal cancer screening; colonoscopy on individual not meeting criteria for high risk G0121
Colorectal cancer screening, such as a colonoscopy, is a preventive measure to detect early signs of cancer in the large intestine. For individuals not at high risk, it's typically recommended at age 50. A small, flexible tube with a camera is used to examine your colon. It's a safe, effective way to catch issues early.
92 services92 patients
Biopsy of large bowel using a flexible endoscope 45380
A biopsy of the large bowel using a flexible endoscope is a procedure where a thin, flexible tube with a camera is inserted through the rectum to examine the bowel. If abnormal tissue is found, a small sample is taken for further examination. This helps in diagnosing conditions like inflammation, polyps, or cancer.
75 services75 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.
50 services44 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 19958 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
$131.15 typical visit price
range $57.12 – $173.08
Typical copayment $32.78 (range $14.28 – $43.27)
Most-billed visit code 99204
Established Patient
$100.68 typical visit price
range $18.36 – $141.05
Typical copayment $25.17 (range $4.59 – $35.26)
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.

75/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice

Reported Quality Measures

Colorectal Cancer Screening
Percentage of adults 50-75 years of age who had appropriate screening for colorectal cancer
100%375 patients5/55-star benchmark: 85%
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.
100%1,070 patients5/55-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.
99%164 patients4/55-star benchmark: 100%
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.
100%513 patients5/55-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.
97%874 patients4/55-star benchmark: 99%
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…
100%835 patients5/55-star benchmark: 97%
Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention
Percentage of patients aged 18 years and older who were screened for tobacco use one or more times within 24 months AND who received tobacco cessation intervention if identified as a tobacco user
Patients screenedForUse: 100% · 183 patients
Patients tobacco: 100% · 183 patients
100%26 patients5/55-star benchmark: 98%
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…
47%874 patients2/55-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…
0%874 patients1/55-star benchmark: 59%
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.

Other Providers at the Same Location NPPES 7

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

RICHARD F CARUSO MD PA
Internal Medicine (Gastroenterology)
1309 SAVANNAH RD, STE B
LEWES, DE 19958
Sussex County (302) 645-6698
LEWES WALK-IN MEDICAL, LLC
Clinic/Center (Urgent Care)
1309 SAVANNAH RD
LEWES, DE 19958
Sussex County (302) 644-1441
TINA DOMBROSKI PAC
Physician Assistant
1309 SAVANNAH RD, SUITE B
LEWES, DE 19958
Sussex County (302) 645-6698
LEWIS MEDICAL CENTER, LLC
Specialist
1309 SAVANNAH RD
LEWES, DE 19958
Sussex County (302) 644-1441
ASHLEY COOKE DC
Chiropractor
1309 SAVANNAH RD
LEWES, DE 19958
Sussex County (302) 652-2225
PRO CHIROPRACTIC & REHABILITATION LLC
Chiropractor
1309 SAVANNAH RD
LEWES, DE 19958
Sussex County (302) 652-2225
EHG GI DE, P.A.
Internal Medicine
1309 SAVANNAH RD
LEWES, DE 19958
Sussex County (615) 263-5579

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 Richard Caruso's NPI number?

The NPI number for Richard Caruso is 1548252265. It was assigned to this individual provider in the NPPES registry on August 18, 2005.

Where is Richard Caruso located?

Richard Caruso practices at 1309 Savannah Rd Ste B, Lewes, DE 19958. The listed phone number is (302) 645-6698.

What is Richard Caruso's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Gastroenterology, with taxonomy code 207RG0100X.

Is Richard Caruso enrolled in Medicare?

Yes. Richard Caruso 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 Richard Caruso accept?

Health plans from Highmark Blue Cross Blue Shield Delaware list Richard Caruso 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.

When was this NPI record last updated?

The NPPES record for Richard Caruso was last updated on March 31, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.