MICHELLE W CARR MD
NPI 1568411916
Family Medicine in Los Alamos, NM


Quality Rating: 78.23 out of 100 score

NPI Status: Active since May 10, 2006

Contact Information

3917 WEST RD
SUITE A
LOS ALAMOS, NM
ZIP 87544
Phone: (505) 661-8900
Fax: (505) 661-8987

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  • Individual
  • Female
  • Years of Experience 28
  • Family Medicine
  • PECOS Enrolled
  • Accepts Medicare Approved Payment

About MICHELLE CARR

Michelle Carr is a primary care provider established in Los Alamos, New Mexico and her medical specialization is Family Medicine with more than 28 years of experience. She graduated from Loyola University Of Chicago, Stritch School Of Medicine in 1996. The healthcare provider is registered in the NPI registry with number 1568411916 assigned on May 2006. The practitioner's primary taxonomy code is 207Q00000X with license number L6817 (TX). The provider is registered as an individual and her NPI record was last updated 2 years ago.

NPI
1568411916
Provider Name
MICHELLE W CARR MD
Gender
Female
Entity Type
Individual
Location Address
3917 WEST RD SUITE A LOS ALAMOS, NM 87544
Location Phone
(505) 661-8900
Location Fax
(505) 661-8987
Mailing Address
3917 WEST RD SUITE A LOS ALAMOS, NM 87544
Mailing Phone
(505) 661-8900
Mailing Fax
(505) 661-8987
Medical School Name
LOYOLA UNIVERSITY OF CHICAGO, STRITCH SCHOOL OF MEDICINE
Graduation Year
1996
Is Sole Proprietor?
No
Enumeration Date
05-10-2006
Last Update Date
10-04-2022
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A primary care provider (PCP) like Michelle Carr sees people with common medical problems. The primary care provider might be a doctor, physician assistant, nurse practitioner or clinic that are usually involved in your long-term care. A PCP might provide preventive care, treat common medical conditions, identify urgent medical problems and refer you to specialists when necessary. Primary care is usually provided in an outpatient facility but if you are admitted to a hospital your PCP may assist in your care. The most common medical conditions seen by primary care providers are: hypertension, upper respiratory tract infections, depression or anxiety, back pain, arthritis, dermatitis, diabetes, urinary tract infections, etc

Michelle Carr is registered with Medicare and accepts claims assignment, this means the provider accepts the approved amount for the cost of rendered services as full payment. Participating providers may not charge beneficiaries more than the approved amount for their services. Please keep in mind that beneficiaries still have to pay a coinsurance or copayment amount for a visit or service.

The provider participated in CMS Quality Payment Program under the Merit-based Incentive Payment System (MIPS) and has an overall final score of 78.23, based on four performance areas: quality, improvement activities, promoting interoperability, and cost. The purpose of this information is to help people with Medicare make informed decisions and incentivize doctors and clinicians to maximize performance.

The typical physician office visit costs for Medicare beneficiaries in this area are: $21.82 for a new patient copayment and $25.16 for an established patient copayment.

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Family Medicine

Taxonomy Code
207Q00000X
Type
Allopathic & Osteopathic Physicians
License No.
L6817
License State
TX
Taxonomy Description
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

  • Ambetter from Arizona Complete Health

    • Choice Bronze HSA - HMO
    • Choice Bronze HSA + Vision + Adult Dental - HMO
    • Clear Gold - HMO
    • Clear Gold + Vision + Adult Dental - HMO
    • Clear Silver - HMO
    • Clear Silver + Vision + Adult Dental - HMO
    • Complete Gold - HMO
    • Complete Gold + Vision + Adult Dental - HMO
    • Complete Silver - HMO
    • Complete Silver + Vision + Adult Dental - HMO
    • Elite Bronze - HMO
    • Elite Bronze + Vision + Adult Dental - HMO
    • Elite Gold - HMO
    • Elite Gold + Vision + Adult Dental - HMO
    • Everyday Bronze - HMO
  • Ambetter from Superior HealthPlan

    • Ambetter Virtual Access Gold (Virtual PCP selection required) - HMO
    • Ambetter Virtual Access Silver (Virtual PCP selection required) - HMO
    • Clear Gold - EPO
    • Clear Gold + Vision + Adult Dental - EPO
    • Clear Silver - EPO
    • Clear Silver + Vision + Adult Dental - EPO
    • Complete Gold - EPO
    • Complete Gold + Vision + Adult Dental - EPO
    • Complete Silver - EPO
    • Complete Silver + Vision + Adult Dental - EPO
    • Everyday Gold - EPO
    • Everyday Gold + Vision + Adult Dental - EPO
    • Focused Silver - EPO
    • Focused Silver + Vision + Adult Dental - EPO
    • Standard Ambetter Virtual Access Gold (Virtual PCP selection required) - HMO
  • Ambetter of Oklahoma

    • Clear Gold - PPO
    • Clear Gold + Vision + Adult Dental - PPO
    • Clear Silver - PPO
    • Clear Silver + Vision + Adult Dental - PPO
    • Complete Silver - PPO
    • Complete Silver + Vision + Adult Dental - PPO
    • Elite Bronze - PPO
    • Elite Bronze + Vision + Adult Dental - PPO
    • Elite Gold - PPO
    • Elite Gold + Vision + Adult Dental - PPO
    • Everyday Bronze - PPO
    • Everyday Bronze + Vision + Adult Dental - PPO
    • Everyday Gold - PPO
    • Everyday Gold + Vision + Adult Dental - PPO
    • Focused Silver - PPO
  • Medicare

  • Medicaid


*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Additional Identifiers

The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State Identifier Issuer
159730401MEDICAID (05)TX 

PECOS Enrollment and Medicare Participation Status

Michelle Carr is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.

What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.

  • Is the provider registered in PECOS? Yes

  • PECOS PAC ID: 446304976

    What is the PECOS Associate Control ID?
    A PAC ID is a unique 10-digit number assigned to an individual or organization healthcare provider in PECOS. The PAC ID is used to link together all the provider information, like tax identification numbers and organizational names. A PAC ID can be connected to multiple Enrollment IDs if an individual or organization has enrolled in PECOS more than once.

  • PECOS Enrollment ID: I20090819000209

    What is the Provider Enrollment ID?
    The Enrollment ID is a unique alphanumeric 15-digit code assigned to each new provider's PECOS enrollment application. The Enrollment ID is used to link together all the provider enrollment information like enrollment type, state, provider specialty, and reassignment of benefits.

  • Accepts Medicare Assignment? Yes

    What does it mean "accepts medicare assignment"?
    When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
    A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.

  • Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes

  • Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes

  • Eligible to Order or Refer a Home Health Agency (HHA): Yes

  • Eligible to Order or Refer Power Mobility Devices: Yes

Provider Referred Orders for Durable Medical Equipment, Devices & Supplies

The following list reflects the services, supplies or durable medical equipment ordered by this provider to a DME supplier on behalf of patients. The information below is derived from Medicare claims data and reflects the BETOS category, HCPCS code information and the number times each service was submitted under the Medicare fee-for-service program.

Durable Medical Equipment

  • Other DME (D1E)

    Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips (HCPCS:A4253)

    4 DME suppliers used 17 Medicare Claims 38 Services Paid

  • Other DME (D1E)

    Filter, disposable, used with positive airway pressure device (HCPCS:A7038)

    4 DME suppliers used 14 Medicare Claims 84 Services Paid

  • Oxygen and supplies (D1C)

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

    4 DME suppliers used 24 Medicare Claims 30 Services Paid

  • Oxygen and supplies (D1C)

    Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate (HCPCS:E1390)

    6 DME suppliers used 98 Medicare Claims 103 Services Paid

  • Oxygen and supplies (D1C)

    Portable oxygen concentrator, rental (HCPCS:E1392)

    2 DME suppliers used 24 Medicare Claims 24 Services Paid

Physician Visit Costs

The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.

For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.

The prices below reflect the costs for new and established patients in the 87544 ZIP code area.

New Patients Visit Costs *

The most utilized procedure code for new patients office visits is 99203

  • Average New Patient Price $87.31
  • Minimum New Patient Price $56.4
  • Maximum New Patient Price $173.32
  • Average New Patient Copayment $21.82
  • Minimum New Patient Copayment $14.1
  • Maximum New Patient Copayment $43.33

Established Patients Visit Costs *

The most utilized procedure code for established patients office visits is 99214

  • Average Established Patient Price $100.67
  • Minimum Established Patient Price $17.1
  • Maximum Established Patient Price $141.02
  • Average Established Patient Copayment $25.16
  • Minimum Established Patient Copayment $4.27
  • Maximum Established Patient Copayment $35.25

* The physician office visit costs information is generated by statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.

Overall MIPS Quality Performance

The Merit-based Incentive Payment System (MIPS) is a way providers could use to participate in CMS Quality Payment Program (QPP). The MIPS program affects clinician reimbursement for Part B covered professional services and also rewards them for improving the quality of patient care and outcomes.

  • Final Score: 78.23 out of 100

    The MIPS program evaluates providers across multiple categories with a specific weight for each category resulting a in a MIPS final score that ranges from 0 to 100 points. The MIPS Final Score determines whether providers receive a negative, neutral or positive MIPS payment adjustment.

  • Quality Score: 74.38

    The Quality category assesses providers performance on clinical practices and patient outcomes under the traditional MIPS program. The quality measures help identify the quality of healthcare processes, outcomes, and patient experiences. The Quality measure category compromises 40% providers final MPIS scores.

    There are six collection types for MIPS quality measures: Electronic Clinical Quality Measures (eCQMs), MIPS Clinical Quality Measures (CQMs), Qualified Clinical Data Registry (QCDR) Measures, Medicare Part B claims measures, CMS Web Interface measures and The Consumer Assessment of Healthcare Providers and Systems (CAHPS) for MIPS Survey.

  • Promoting Interoperability Score: N/A

    The Interoperability category measures the providers ability to use technology to exchange and make use of healthcare information in a way that is less burdensome and improves outcomes. The Interoperability measure category compromises 25% providers final MPIS scores.

    The MIPS Interoperability measure focuses on the use of certified electronic health record technology (CEHRT) to improve patient access health information, the exchange of information between clinicians and pharmacies and the systematic collection, analysis, and interpretation of healthcare data.

  • Improvement Activities Score: 40

    The Improvement Activities performance category evaluates the providers participation in clinical activities that support the improvement of clinical practice, care delivery, and outcomes. Providers have the option to choose 2 to 4 activities from an inventory of over 100 improvement activities. Providers typically choose the activities that best fit their needs. The improvement activities measure category compromises 15% providers final MPIS scores.

    The Improvement measures aim to better patient engagement, patient safety and other areas of patient care. The Improvement Activities category compromises 15% of providers final MPIS scores.

  • Cost Score: N/A

    The Cost performance category asses the amount and types of services provided and how clinicians coordinate care and seek improvement of health outcomes by ensuring patients receive the appropriate services.

    Although providers don't determine the price of healthcare services they are important in delivering high-quality care at a reasonable cost. The Cost measures category compromises 20% of providers final MPIS scores.

  • Cost Score: N/A

    The Cost performance category asses the amount and types of services provided and how clinicians coordinate care and seek improvement of health outcomes by ensuring patients receive the appropriate services.

    Although providers don't determine the price of healthcare services they are important in delivering high-quality care at a reasonable cost. The Cost measures category compromises 20% of providers final MPIS scores.

Clinician Services

The following Healthcare Common Procedure Coding System (HCPCS) codes were publicly reported as the top services rendered by this provider under the Medicare program for the year 2020. The reported codes are based on the top 5 codes for each available specialty, excluding evaluation and management codes.

  • 166

    Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit (HCPCS:G0439)

  • 71

    Administration of influenza virus vaccine (HCPCS:G0008)

  • 42

    Vaccine for influenza for injection into muscle (HCPCS:90662)

  • 22

    Hemoglobin a1c level (HCPCS:83036)

  • 18

    Routine ekg using at least 12 leads including interpretation and report (HCPCS:93000)

  • 16

    Administration of pneumococcal vaccine (HCPCS:G0009)

Hospital Affiliations

Hospital affiliation is identified through self-reporting data, inpatient, outpatient, physician and ancillary service claims linked by the medical claims NPI number and place of service code. Additionally, to further determine provider hospital affiliation the clinician must have provided services to at least three patients on three different dates in the last 12 months. Michelle Carr is affiliated with the following medical facilities:

Hospital Name Address Phone Hospital Type Overall Rating
CHRISTUS ST VINCENT REGIONAL MEDICAL CENTER455 ST MICHAEL'S DRIVE
SANTA FE, NM 87505
(505) 913-3361Acute Care Hospitals
PRESBYTERIAN ESPANOLA HOSPITAL1010 SPRUCE STREET
ESPANOLA, NM 87532
(505) 753-1502Acute Care Hospitals
LOS ALAMOS MEDICAL CENTER3917 WEST ROAD
LOS ALAMOS, NM 87544
(505) 662-4201Acute Care Hospitals

Reviews for MICHELLE W CARR MD

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NPI Validation Check Digit Calculation


The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.

Start with the original NPI number, the last digit is the check digit and is not used in the calculation.
1568411916
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
2512881292
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 5 + 1 + 2 + 8 + 8 + 1 + 2 + 9 + 2 + 24 = 64
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
70 - 64 = 66

The NPI number 1568411916 is valid because the calculated check digit 6 using the Luhn validation algorithm matches the last digit of the original NPI number.

Other Providers at the Same Location


The following 20 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1710982681DR. RICHARD WELDON HONSINGER JR. MD
Individual
Allergy & Immunology3917 WEST RD SUITE 150
LOS ALAMOS, NM 87544
(505) 662-4351
1487652780DR. JAMES JOSEPH ZIOMEK MD
Individual
Internal Medicine3917 WEST RD SUITE 150
LOS ALAMOS, NM 87544
(505) 662-4351
1528066826DR. ROBERT JOHN THOMSEN MD
Individual
Dermatology3917 WEST RD SUITE 150
LOS ALAMOS, NM 87544
(505) 662-4351
1629076864DR. BILLY MICHAEL JACKSON MD
Individual
Surgery3917 WEST RD SUITE 150
LOS ALAMOS, NM 87544
(505) 662-4351
1366440141DR. KATHRYN GENEVIEVE BARNARD M.D.
Individual
Internal Medicine3917 WEST RD SUITE 138
LOS ALAMOS, NM 87544
(505) 661-9030
1790779007DR. SHELLEY P SCHOONOVER MD
Individual
Pediatrics3917 WEST RD STE 128
LOS ALAMOS, NM 87544
(505) 662-4234
1922092139DR. MARY ELLEN SLAUGHTER MD
Individual
Pediatrics3917 WEST RD SUITE 128
LOS ALAMOS, NM 87544
(505) 662-4234
1821082033DR. JOHN BENNETT NEAL MD
Individual
Pediatrics3917 WEST RD #128
LOS ALAMOS, NM 87544
(505) 662-3073
1730173949DR. MICHAEL W NICHOLS MD
Individual
Pediatrics3917 WEST RD #128
LOS ALAMOS, NM 87544
(505) 662-4234
1902890593 SUSAN M GISLER CNP
Individual
Nurse Practitioner (Pediatrics)3917 WEST RD STE 128
LOS ALAMOS, NM 87544
(505) 662-4234
1942290283DR. JACQUELINE ANNE KROHN MD MPH
Individual
Pediatrics3917 WEST RD SUITE 136
LOS ALAMOS, NM 87544
(505) 662-9620
1871563536 GRETCHEN L ANDERSON RN, CS, MS(N),FNP
Individual
Nurse Practitioner (Family)3917 WEST RD SUITE A
LOS ALAMOS, NM 87544
(505) 661-8900
1568431955 CHRISTINE CARLOS MD
Individual
Obstetrics & Gynecology (Gynecology)3917 WEST RD SUITE 250
LOS ALAMOS, NM 87544
(505) 662-4412
1386604304NORTHERN NEW MEXICO UROLOGY LLC
Organization
Specialist3917 WEST RD SUITE 137
LOS ALAMOS, NM 87544
(505) 661-8500
1093778425DR. LAURENCE GODDARD MD
Individual
Internal Medicine3917 WEST RD SUITE A
LOS ALAMOS, NM 87544
(505) 661-8900
1922058114LOS ALAMOS WOMENS HEALTH SERVICES, PC
Organization
Obstetrics & Gynecology3917 WEST RD SUITE 250
LOS ALAMOS, NM 87544
(505) 662-4412
1023054913DR. LORI S. WHITLEY MD
Individual
Dermatology3917 WEST RD SUITE 150
LOS ALAMOS, NM 87544
(505) 662-4351
1245263730 TATIANA CANNING
Individual
Hospitalist3917 WEST RD
LOS ALAMOS, NM 87544
(505) 753-1866
1679506141 DANIELLE DUQUETTE BRIDGE MD
Individual
Obstetrics & Gynecology3917 WEST RD
LOS ALAMOS, NM 87544
(509) 881-8513
1902839483 ROSS EDWARD BRIDGE MD
Individual
Family Medicine3917 WEST RD SUITE 150
LOS ALAMOS, NM 87544
(505) 662-4351

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1568411916, enumerated in the NPI registry as an "individual" on May 10, 2006

The provider is located at 3917 West Rd Suite A Los Alamos, Nm 87544 and the phone number is (505) 661-8900

The provider's speciality is Family Medicine with taxonomy code 207Q00000X

The provider has more than 28 years of experience. She graduated from Loyola University Of Chicago, Stritch School Of Medicine in 1996.

The provider might be accepting Accepts: Ambetter from Arizona Complete Health, Ambetter. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.

Yes, as of June 14, 2024 the provider is registered in PECOS and is eligible to order health care services or supplies for Medicare patients. If you are a beneficiary the provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.

Medicare beneficiaries should expect a typical cost of $87.31 with an average copayment of $21.82 for new patient appointments. Established patients should expect a typical charge of $100.67 and an average copayment of 25.16. Please review your insurance plan or contact the provider directly to determine your specific costs.

The most common procedures or services performed by this practitioner are: Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit, Administration of influenza virus vaccine, Vaccine for influenza for injection into muscle, Hemoglobin a1c level, Routine ekg using at least 12 leads including interpretation and report and Administration of pneumococcal vaccine.

The practitioner is affiliated to the following hospital(s): CHRISTUS ST VINCENT REGIONAL MEDICAL CENTER, PRESBYTERIAN ESPANOLA HOSPITAL and LOS ALAMOS MEDICAL CENTER. Hospital affiliations are identified through self-reporting data and service claims based on the place of service.

This NPI record was last updated on May 10, 2006. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
NPI Profile data is regularly updated with the latest NPI registry information, if you would like to update or remove your NPI Profile in this website please contact us.