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ALFRED C CARUSO M.D.
NPI 1568549269
Internal Medicine - Pulmonary Disease in Kansas City, MO

Active since November 01, 2006PECOS EnrolledAccepts Medicare Assignment
80.02/100
CMS Quality Rating
1004 CARONDELET DR, SUITE 410, KANSAS CITY, MO 64114(816) 389-6100(816) 389-6150 Get Directions Write a Review

NPPES record last updated: April 1, 2015. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Alfred C Caruso M.d. NPPES

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

ALFRED C CARUSO M.D. (NPI 1568549269) is an individual pulmonary disease provider in Kansas City, Missouri, licensed in Missouri (R8H50) and active in the NPI registry since November 2006. He is enrolled in Medicare PECOS, is affiliated with Menorah Medical Center, and is a graduate of Other (1983).

NPPES Registry Identity

NPI1568549269
Entity TypeIndividualMale
Primary Taxonomy207RP1001X
Provider Legal NameALFRED C CARUSOCredential: M.D.
Location Address1004 CARONDELET DR, SUITE 410Kansas City, MO 64114-4802
Mailing AddressPo Box 872332Kansas City, MO 64187-2332 · (816) 389-6100 · Fax (816) 389-6150
Phone(816) 389-6100
Fax(816) 389-6150
Sole ProprietorNo
Medical School CMSOtherGraduated 1983
Enumeration DateNovember 1, 2006
Last NPPES UpdateApril 1, 2015
✔ NPI 1568549269 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyInternal Medicine · Pulmonary DiseaseAllopathic & Osteopathic Physicians
Taxonomy Code207RP1001X
Licenses✔ Licensed in MO · R8H50✔ Licensed in KS · 04-24867
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.
Also ListedInternal Medicine · Sleep MedicineTaxonomy 207RS0012X · License R8H50 (MO)
1004 CARONDELET DR, Kansas City, MO 64114
Open in Google Maps ↗

Other Identifiers 9

Medicare UPIN130758003KS
Medicare UPINE08984
Medicaid208944900MO
Medicare PINMA1922008MO
Other14429021MO · Bcbs Of Kc
Medicare PINY36000046MO
Medicaid100333270CKS
Medicaid1568549269MO
Medicare PINKA2102001KS

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Sunflower Health Plan, Ambetter Health, Ambetter Health of Delaware and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Alfred C Caruso 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 ID6204870496
PECOS Enrollment IDI20050617000959, I20110303000448
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.

Medicare Billing Reassignments

2

Medicare enrollment records show Alfred Caruso reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Prime Healthcare Kansas City - Physician Services LLC
0.1 mi
Family Medicine
930 CARONDELET DR STE 201
Kansas City, MO 64114
  • Reassigned Medicare billing, Missouri enrollment
  • 180 clinicians in this Medicare group
NPI 1427449487 (816) 389-6100
Kc Hospitalists, P.A.
3.1 mi
Hospitalist
5701 W 119TH ST, SUITE 135
Overland Park, KS 66209
  • Reassigned Medicare billing, Kansas and Missouri enrollments
  • Medicare enrollment name: Kc Hospitalists PA
  • 50 clinicians in this Medicare group
NPI 1922348069 (816) 268-9123

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims 7

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.

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.
906 services361 patients
Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes 99233
Follow-up hospital inpatient care per day typically involves a 35-minute check-up by your healthcare provider. This service includes monitoring your health progress, adjusting your treatment plan if needed, and answering any questions you may have about your condition or care.
438 services226 patients
Hospital discharge day management, more than 30 minutes 99239
Hospital discharge day management over 30 minutes involves a detailed process to ensure a smooth transition from hospital to home. It includes final examinations, discussion of your hospital stay, post-discharge instructions, and coordinating follow-up care.
228 services220 patients
Subsequent hospital care with straightforward or low level of medical decision making, per day, if using time, at least 25 minutes 99231
Follow-up hospital inpatient care is a daily service where a healthcare professional checks on your health progress during your hospital stay. Each session typically lasts 15 minutes, involving updates on your condition and adjustments to your treatment plan, if necessary.
171 services104 patients
Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes 99223
Initial hospital inpatient care per day, typically 70 minutes, refers to the daily medical service provided to patients admitted to the hospital. This includes a comprehensive evaluation, diagnosis, treatment plan, and monitoring of your health condition. It ensures your well-being during your hospital stay.
44 services44 patients
Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes 99222
Initial hospital inpatient care is a service where a healthcare provider spends about 50 minutes per day overseeing your care while you're admitted in the hospital. This includes reviewing your health status, planning your treatment, and ensuring your safety and comfort.
29 services29 patients

Hospital Affiliations CMS Care Compare 2

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

Menorah Medical Center

Acute Care Hospitals · Overland Park, KS
3/5 CMS rating
OwnershipProprietary
CMS Certification Number170182
Location5721 West 119th StreetOverland Park, KS 66209 · Johnson County
Emergency services

Lee's Summit Medical Center

Acute Care Hospitals · Lees Summit, MO
4/5 CMS rating
OwnershipProprietary
CMS Certification Number260190
Location2100 SE Blue ParkwayLees Summit, MO 64063 · Jackson County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 64114 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
$127.61 typical visit price
range $55.29 – $168.52
Typical copayment $31.90 (range $13.82 – $42.13)
Most-billed visit code 99204
Established Patient
$97.82 typical visit price
range $17.60 – $137.20
Typical copayment $24.45 (range $4.40 – $34.30)
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.

80.02/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality78.41
Improvement Activities40
Cost59.79

Referred Medical Equipment & Supplies CMS DME claims 15

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

Tubing with integrated heating element for use with positive airway pressure device A4604
DME-Other DME · category DE001N
6 suppliers21 claims21 services$28.00 avg. paid by Medicare
Full face mask used with positive airway pressure device, each A7030
DME-Other DME · category DE001N
9 suppliers55 claims55 services$76.29 avg. paid by Medicare
Face mask interface, replacement for full face mask, each A7031
DME-Other DME · category DE001N
9 suppliers49 claims142 services$28.82 avg. paid by Medicare
Cushion for use on nasal mask interface, replacement only, each A7032
DME-Other DME · category DE001N
10 suppliers40 claims226 services$15.82 avg. paid by Medicare
Pillow for use on nasal cannula type interface, replacement only, pair A7033
DME-Other DME · category DE001N
6 suppliers38 claims217 services$12.85 avg. paid by Medicare
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap A7034
DME-Other DME · category DE001N
11 suppliers90 claims90 services$47.64 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.

CARONDELET EYE CARE ASSOCIATES PC
Ophthalmology
1004 CARONDELET DR, SUITE 400
KANSAS CITY, MO 64114
Jackson County (816) 942-8333
BECKY GRAHAM, D.O., P.C.
Obstetrics & Gynecology
1004 CARONDELET DR, SUITE 460
KANSAS CITY, MO 64114
Jackson County (816) 388-2229
DR. STEPHEN D KRUEGER M.D.
Obstetrics & Gynecology
1004 CARONDELET DR, SUITE 315
KANSAS CITY, MO 64114
Jackson County (816) 942-3339
MEGAN R LOEB M.D.
Pediatrics
1004 CARONDELET DR, SUITE 350
KANSAS CITY, MO 64114
Jackson County (816) 942-8644
DR. JAMES ROBERT OVERLEASE III M.D.
Ophthalmology
1004 CARONDELET DR, STE. 405
KANSAS CITY, MO 64114
Jackson County (816) 943-1123
DR. ANN BAILEY ROBINSON MD
Otolaryngology
1004 CARONDELET DR, SUITE 450
KANSAS CITY, MO 64114
Jackson County (816) 942-7200
AUNDRIA L SPEROPOULOS M.D.
Pediatrics
1004 CARONDELET DR, SUITE 350
KANSAS CITY, MO 64114
Jackson County (816) 942-8644
MRS. VANESSA N. JOHNSON P.A.
Physician Assistant (Medical)
1004 CARONDELET DR, SUITE 330
KANSAS CITY, MO 64114
Jackson County (816) 914-6400

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 Alfred Caruso's NPI number?

The NPI number for Alfred Caruso is 1568549269. It was assigned to this individual provider in the NPPES registry on November 1, 2006.

Where is Alfred Caruso located?

Alfred Caruso practices at 1004 Carondelet Dr Suite 410, Kansas City, MO 64114. The listed phone number is (816) 389-6100.

What is Alfred Caruso's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Pulmonary Disease, with taxonomy code 207RP1001X.

Is Alfred Caruso enrolled in Medicare?

Yes. Alfred 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.

Which organizations bill Medicare for Alfred Caruso's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Alfred Caruso reassigns Medicare benefits to 2 organizations: Prime Healthcare Kansas City - Physician Services LLC (Kansas City, MO) and Kc Hospitalists, P.A. (Overland Park, KS). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Alfred Caruso's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Alfred Caruso accept?

Health plans from Ambetter Health, Ambetter Health of Delaware, Ambetter from Sunflower Health Plan, Ambetter of Oklahoma and Blue Cross and Blue Shield of Kansas City list Alfred 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.

Is Alfred Caruso affiliated with any hospitals?

According to CMS data, Alfred Caruso is affiliated with Menorah Medical Center and Lee's Summit Medical Center.

When was this NPI record last updated?

The NPPES record for Alfred Caruso was last updated on April 1, 2015. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 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.