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STEPHEN JOSEPH CAPPS M.D.
NPI 1568552297
Ophthalmology in Hendersonville, NC

Active since October 13, 2006PECOS EnrolledAccepts Medicare Assignment
96.38/100
CMS Quality Rating
630 5TH AVE W, HENDERSONVILLE, NC 28739(828) 693-0747(828) 693-0947 Get Directions Write a Review

NPPES record last updated: April 30, 2013. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Stephen Joseph Capps M.d. NPPES

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

STEPHEN JOSEPH CAPPS M.D. (NPI 1568552297) is an individual ophthalmology provider in Hendersonville, North Carolina, licensed in North Carolina (2012-02008) and active in the NPI registry since October 2006. He is enrolled in Medicare PECOS and is a graduate of University Of Arizona College Of Medicine (1979).

NPPES Registry Identity

NPI1568552297
Entity TypeIndividualMale
Primary Taxonomy207W00000X
Provider Legal NameSTEPHEN JOSEPH CAPPSCredential: M.D.
Location Address630 5TH AVE WHendersonville, NC 28739-4206
Mailing Address630 5th Ave WHendersonville, NC 28739-4206 · (828) 693-0747 · Fax (828) 693-0947
Phone(828) 693-0747
Fax(828) 693-0947
Sole ProprietorNo
Medical School CMSUniversity Of Arizona College Of MedicineGraduated 1979
Enumeration DateOctober 13, 2006
Last NPPES UpdateApril 30, 2013
✔ NPI 1568552297 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOphthalmologyAllopathic & Osteopathic Physicians
Taxonomy Code207W00000X
Licenses✔ Licensed in NC · 2012-02008✔ Licensed in LA · L7761R
Definition
An ophthalmologist has the knowledge and professional skills needed to provide comprehensive eye and vision care. Ophthalmologists are medically trained to diagnose, monitor and medically or surgically treat all ocular and visual disorders. This includes problems affecting the eye and its component structures, the eyelids, the orbit and the visual pathways. In so doing, an ophthalmologist prescribes vision services, including glasses and contact lenses.
630 5TH AVE W, Hendersonville, NC 28739
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Other Identifiers 7

Medicare PIN5N334LA
Medicare PIN180014848LA
Medicare UPINE65825
Medicaid5922416NC
Medicare PIN5N334B612LA
Medicare NSC0435280002LA
Medicaid1927112LA

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Absolute Total Care, Ambetter of North Carolina, AmeriHealth Caritas Next 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

Stephen Joseph Capps 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 ID4789779950
PECOS Enrollment IDI20130225000226
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.

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.
671 services406 patients
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.
561 services538 patients
Imaging of retina 92134
Imaging of the retina is a non-invasive procedure that captures detailed images of your eye's interior. This helps detect conditions like macular degeneration or retinal detachment. It's painless and takes only a few minutes.
439 services399 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.
157 services157 patients
Established patient complete exam of visual system 92014
An established patient complete exam of the visual system involves a thorough check of your eyes and vision. It assesses eye health, checks for diseases, and measures your ability to see clearly at different distances. It's a routine, non-invasive procedure.
130 services129 patients
Exam of visual field with extended testing 92083
An extended visual field exam is a detailed test to evaluate your peripheral (side) vision. It helps to detect any potential blind spots which may not be noticeable in daily life. These could be caused by eye diseases like glaucoma, or neurological conditions.
88 services87 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 28739 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
$125.01 typical visit price
range $54.12 – $165.09
Typical copayment $31.25 (range $13.53 – $41.27)
Most-billed visit code 99204
Established Patient
$67.72 typical visit price
range $17.21 – $134.61
Typical copayment $16.93 (range $4.30 – $33.65)
Most-billed visit code 99213
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.

96.38/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Individually scored
Quality92.76
Improvement Activities40

Reported Quality Measures

Diabetes: Eye Exam
99%345 patients4/55-star benchmark: 100%
Glaucoma Intraocular Pressure Reduction
94%89 patients
Primary Open-Angle Glaucoma (POAG): Optic Nerve Evaluation
15%190 patients
Primary Open-Angle Glaucoma (POAG): Reduction of Intraocular Pressure (IOP) by 15% OR Documentation of a Plan of Care
89%195 patients
Use of High-Risk Medications in Older Adults
Lower rates are better for this measure.
Patients appropriateDiagnosis: 0% · 2,127 patients
Patients totalRate: 0% · 2,127 patients
0%2,127 patients5/55-star benchmark: 100%
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 4

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

DR. ROBERT PAUL LABORDE M.D.
Ophthalmology
630 5TH AVE W
HENDERSONVILLE, NC 28739
Henderson County (828) 693-0747
GENE AUSTIN TAYLOR KRISHINGNER MD
Urology
630 5TH AVE W
HENDERSONVILLE, NC 28739
Henderson County (828) 259-2357
COLIN PATRICK BIRD MD
Colon & Rectal Surgery
630 5TH AVE W
HENDERSONVILLE, NC 28739
Henderson County (828) 259-2357
LABORDE EYE GROUP HOME OF THE MACULA CENTER OF N CAROLINA PLLC
Ophthalmology
630 5TH AVE W
HENDERSONVILLE, NC 28739
Henderson County (828) 693-0747

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 Stephen Capps's NPI number?

The NPI number for Stephen Capps is 1568552297. It was assigned to this individual provider in the NPPES registry on October 13, 2006.

Where is Stephen Capps located?

Stephen Capps practices at 630 5th Ave W, Hendersonville, NC 28739. The listed phone number is (828) 693-0747.

What is Stephen Capps's specialty?

The primary specialty registered for this NPI is Ophthalmology with taxonomy code 207W00000X.

Is Stephen Capps enrolled in Medicare?

Yes. Stephen Capps 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 Stephen Capps accept?

Health plans from Ambetter from Absolute Total Care, Ambetter of North Carolina, AmeriHealth Caritas Next, Blue Cross and Blue Shield of NC and First Choice Next and 2 other insurers list Stephen Capps 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 Stephen Capps was last updated on April 30, 2013. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 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.