DR. CHARLES A CRATON MD
NPI 1568435501
Internal Medicine in Douglasville, GA

Q: What is Charles Craton's NPI number?

The NPI number for Charles Craton is 1568435501. It was assigned to this individual provider in the NPPES registry on February 9, 2006.

Q: What is Charles Craton's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Q: When was this NPI record last updated?

The NPPES record for Charles Craton was last updated on December 6, 2019. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since February 09, 2006PECOS EnrolledAccepts Medicare Assignment

92.93/100

CMS Quality Rating

8820 HOSPITAL DR, DOUGLASVILLE, GA 30134(770) 947-3000(770) 947-3012 Get Directions Write a Review

NPPES record last updated: December 6, 2019. Verified against the NPPES registry weekly; last sync: July 26, 2026.

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About Dr. Charles A Craton Md NPPES

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

DR. CHARLES A CRATON MD (NPI 1568435501) is an individual internal medicine provider in Douglasville, Georgia, licensed in Georgia (041539) and active in the NPI registry since February 2006. He is enrolled in Medicare PECOS, is affiliated with Wellstar Kennestone Regional Medical Center, and is a graduate of Medical College Of Georgia School Of Medicine (1993).

NPPES Registry Identity

NPI1568435501

Entity TypeIndividualMale

Primary Taxonomy207R00000X

Provider Legal NameDR. CHARLES A CRATONCredential: MD

Location Address8820 HOSPITAL DRDouglasville, GA 30134-2266

Mailing Address8820 Hospital DrDouglasville, GA 30134-2266 · (770) 947-3000 · Fax (770) 947-3012

Phone(770) 947-3000

Fax(770) 947-3012

Sole ProprietorNo

Medical School CMSMedical College Of Georgia School Of MedicineGraduated 1993

Enumeration DateFebruary 9, 2006

Last NPPES UpdateDecember 6, 2019

✔ NPI 1568435501 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207R00000X

License✔ Licensed in GA · 041539

Definition

A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.

8820 HOSPITAL DR, Douglasville, GA 30134

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Accepted Insurance

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

Dr. Charles A Craton 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 ID4688755192

PECOS Enrollment IDI20080122000523

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 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.

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.

430 services215 patients

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

An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.

184 services184 patients

Administration of influenza virus vaccine G0008

The administration of the influenza virus vaccine, also known as the flu shot, is a simple procedure to protect against the flu. A healthcare provider injects a small dose of the vaccine into your arm. This stimulates your immune system to produce antibodies, which will help your body fight off the flu if exposed.

69 services65 patients

Influenza vaccine split virus, preservative free 90662

The Influenza Vaccine Split Virus, preservative-free, is a flu shot to protect against the influenza virus. It is made from parts of inactivated flu viruses and doesn't contain preservatives, reducing potential side effects. It helps your body develop immunity to the flu.

66 services62 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 services48 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.

20 services17 patients

Hospital Affiliations CMS Care Compare 4

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

Wellstar Paulding Medical Center

Acute Care Hospitals · Hiram, GA

4/5 CMS rating

OwnershipVoluntary non-profit - Other

CMS Certification Number110042

Location2518 Jimmy Lee Smith ParkwayHiram, GA 30141 · Paulding County

Wellstar Cobb Medical Center

Acute Care Hospitals · Austell, GA

2/5 CMS rating

OwnershipVoluntary non-profit - Other

CMS Certification Number110143

Location3950 Austell RdAustell, GA 30106 · Cobb County

Birthing friendly

Wellstar Douglas Medical Center

Acute Care Hospitals · Douglasville, GA

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number110184

Location8954 Hospital DriveDouglasville, GA 30134 · Douglas County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 30134 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

$100.20 typical visit price

range $18.22 – $140.40

Typical copayment $25.05 (range $4.55 – $35.10)

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.

92.93/100

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

Scored through an Alternative Payment Model

Quality

80.38

Promoting Interoperability

100

Improvement Activities

Referred Medical Equipment & Supplies CMS DME claims 5

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

Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253

DME-Other DME · category DE017N

13 suppliers35 claims93 services$5.80 avg. paid by Medicare

Lancets, per box of 100 A4259

DME-Medical/Surgical Supplies · category DA000N

9 suppliers17 claims23 services$0.94 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

1 supplier12 claims12 services$15.11 avg. paid by Medicare

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

DME-Oxygen and Supplies · category DC002N

1 supplier12 claims12 services$66.18 avg. paid by Medicare

Supply allowance for therapeutic continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service K0553

DME-Other DME · category DE017N

1 supplier11 claims11 services$185.12 avg. paid by Medicare

Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

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Other Providers at the Same Location NPPES 16

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

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