DR. LOREN J DECARLO D.O.
NPI 1629003462
Family Medicine in Capac, MI

Q: What is Loren Decarlo's NPI number?

The NPI number for Loren Decarlo is 1629003462. It was assigned to this individual provider in the NPPES registry on July 11, 2006.

Q: What is Loren Decarlo's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Q: When was this NPI record last updated?

The NPPES record for Loren Decarlo was last updated on March 21, 2011. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since July 11, 2006PECOS EnrolledAccepts Medicare Assignment

82.67/100

CMS Quality Rating

117 S MAIN ST, CAPAC, MI 48014(810) 395-4840(810) 395-7551 Get Directions Write a Review

NPPES record last updated: March 21, 2011. Verified against the NPPES registry weekly; last sync: July 19, 2026.

On this page

About Dr. Loren J Decarlo D.o. NPPES

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

DR. LOREN J DECARLO D.O. (NPI 1629003462) is an individual family medicine provider in Capac, Michigan, licensed in Michigan (5101013942) and active in the NPI registry since July 2006. He is enrolled in Medicare PECOS, is affiliated with Henry Ford Macomb Hospital, and is a graduate of Michigan State University College Of Osteopathic Medicine (1998).

NPPES Registry Identity

NPI1629003462

Entity TypeIndividualMale

Primary Taxonomy207Q00000X

Provider Legal NameDR. LOREN J DECARLOCredential: D.O.

Location Address117 S MAIN STCapac, MI 48014-3715

Mailing Address117 S Main StCapac, MI 48014-3715 · (810) 395-4840 · Fax (810) 395-7551

Phone(810) 395-4840

Fax(810) 395-7551

Sole ProprietorYes

Medical School CMSMichigan State University College Of Osteopathic MedicineGraduated 1998

Enumeration DateJuly 11, 2006

Last NPPES UpdateMarch 21, 2011

✔ NPI 1629003462 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207Q00000X

License✔ Licensed in MI · 5101013942

Definition

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.

117 S MAIN ST, Capac, MI 48014

Open in Google Maps ↗

Other Identifiers 3

Medicaid4735675MI

Medicare UPINH48145MI

Medicare ID-Type Unspecified0P14820 001MI

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Care Network of Michigan, Blue Cross Blue Shield of Michigan Mutual Insurance Company, McLaren Health Plan Community 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. Loren J Decarlo D.o. 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 ID7012981756

PECOS Enrollment IDI20040823000318

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 31

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, 20-29 minutes 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.

826 services290 patients

Insertion of needle into vein for collection of blood sample 36415

This procedure involves inserting a small needle into a vein, typically in your arm, to collect a blood sample. It's a quick and simple process to help diagnose or monitor health conditions. You may feel a small prick, but discomfort is minimal.

569 services283 patients

Established patient office or other outpatient visit, 30-39 minutes 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.

321 services193 patients

Injection, triamcinolone acetonide, not otherwise specified, 10 mg J3301

Triamcinolone acetonide is a medication used to reduce inflammation in the body. It's given as a 10 mg injection for conditions like allergies, arthritis, or skin problems. The injection helps to decrease swelling, redness, and itching.

199 services29 patients

Hemoglobin a1c level 83036

Hemoglobin A1c (HbA1c) is a test that measures your average blood sugar level over the past 2-3 months. It's used to monitor how well diabetes is being controlled. High levels may indicate that your diabetes treatment plan needs adjustment.

152 services80 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.

141 services98 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.

140 services140 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.

122 services119 patients

Injection, ketorolac tromethamine, per 15 mg J1885

Ketorolac tromethamine is a medication administered through injection, often used to manage moderate to severe pain. Each 15 mg dose helps to reduce hormones causing inflammation and pain in the body. It is not recommended for long-term use.

96 services16 patients

Injection of drug or substance under skin or into muscle 96372

This procedure involves administering medication directly under the skin or into a muscle. A small needle is used to inject the drug, allowing it to be absorbed quickly into the bloodstream. It's a common method for delivering a variety of medications.

93 services43 patients

Influenza vaccine, quadrivalent derived from cell cultures, preservative and antibiotic free 90674

The quadrivalent influenza vaccine is a flu shot that protects against four different flu viruses. Derived from cell cultures, it is free of preservatives and antibiotics. It's a safe and effective way to reduce your risk of getting the flu.

74 services73 patients

Urine microalbumin (protein) analysis 82044

Urine microalbumin analysis is a test that measures the amount of a protein called albumin in your urine. This protein is usually present in very small amounts, but higher levels can indicate kidney issues. The test is non-invasive and involves a simple urine sample.

59 services56 patients

Creatinine level to test for kidney function or muscle injury 82570

A creatinine level test measures the amount of creatinine in your blood. This substance is a waste product from normal muscle use. Higher levels can indicate possible kidney dysfunction or muscle injury. This test helps monitor kidney health.

51 services49 patients

Influenza vaccine, quadrivalent, preservative free, 0.5 ml dosage 90686

The quadrivalent influenza vaccine is a shot to protect you from four different flu viruses. It's preservative-free and given in a 0.5 ml dose. It helps your body build immunity to the flu, reducing your risk of getting sick.

49 services49 patients

Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report 93000

An electrocardiogram (ECG) is a non-invasive test that records your heart's electrical activity. Using 12 leads attached to your body, it captures data to help identify heart conditions. A doctor interprets the results and provides a report.

49 services48 patients

Aspiration and/or injection of fluid from large joint 20610

This procedure involves using a needle to remove (aspiration) or introduce (injection) fluid into a large joint like the knee or hip. It can help diagnose conditions, relieve discomfort, or deliver medication directly to the joint.

46 services23 patients

Administration of pneumococcal vaccine G0009

The pneumococcal vaccine helps protect against pneumococcal bacteria, which can cause severe infections like pneumonia and meningitis. The vaccine is given as an injection, typically in the arm. It's recommended for infants, older adults, and those with certain health conditions.

39 services39 patients

Injection, methylprednisolone sodium succinate, up to 125 mg J2930

Methylprednisolone sodium succinate is a steroid medication injected into a muscle or vein. It helps reduce inflammation and immune response. It's used for various conditions like allergies, arthritis, breathing problems, or skin diseases. It's important to follow your doctor's instructions.

37 services23 patients

Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit G0438

An annual wellness visit is a yearly appointment with your doctor to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's an opportunity to discuss your health status and goals and get a plan tailored for you.

29 services29 patients

Amplifed dna or rna probe detection of severe acute respiratory syndrome coronavirus 2 (covid-19) antigen 87635

This is a lab test that detects the presence of COVID-19 in your body. It uses a technique to amplify the virus's genetic material, either DNA or RNA, making it easier to identify. A positive result indicates an active infection.

28 services24 patients

Transitional care management services for problem of high complexity 99496

Transitional care management services are designed to ensure a smooth transition from a hospital to home or another care setting for patients with complex health issues. These services include medication management, patient education, and coordination with healthcare providers.

24 services23 patients

Detection test by immunoassay with direct visual observation for severe acute respiratory syndrome coronavirus 2 (covid-19) 87811

This is a test to detect COVID-19, the virus causing severe respiratory illness. It uses a method called immunoassay, which identifies the virus by its unique proteins. The test is directly observed for accuracy. It helps determine if you're currently infected.

22 services20 patients

Test to measure expiratory airflow and volume 94010

This test, known as spirometry, assesses how well your lungs work. It measures how much air you can inhale, how much you can exhale and how quickly you can exhale. It's non-invasive and helps diagnose conditions like asthma or COPD.

22 services22 patients

Pneumococcal vaccine, 13-valent 90670

The 13-valent pneumococcal vaccine is a shot that helps protect against 13 types of bacteria that can cause serious infections like pneumonia and meningitis. It's often recommended for children under 2 and adults over 65, or people with certain health conditions.

21 services21 patients

Transitional care management services for problem of moderate complexity 99495

Transitional care management services focus on coordinating and managing your care after you leave the hospital. For moderate complexity problems, this involves managing your medications, arranging further treatments, and ensuring you have the necessary follow-ups.

20 services18 patients

X-ray of chest, 2 views 71046

A chest X-ray, 2 views, is a quick, painless test that creates pictures of the structures inside your chest, such as your heart, lungs, and blood vessels. Two different angles are used to get a comprehensive view. This helps in diagnosing conditions like pneumonia, heart problems, or lung cancer.

19 services16 patients

Detection test by immunoassay with direct visual observation for influenza virus 87804

This is a test that identifies the influenza virus in your body. It works by using an immunoassay, a method that detects the presence of the virus through an immune response. The results are directly observable, making it a quick and efficient way to diagnose flu.

19 services17 patients

Removal of impacted ear wax by washing 69209

Impacted ear wax removal by washing, also known as ear irrigation, involves using a pressurized flow of water to break up and dislodge the ear wax. This safe procedure helps restore normal hearing and relieve discomfort caused by the blockage.

18 services17 patients

Pneumococcal vaccine, 23-valent 90732

The 23-valent pneumococcal vaccine is an injection that helps protect against serious infections caused by 23 types of pneumococcal bacteria. It's vital for those at risk, like older adults or people with certain health conditions, to prevent pneumonia, meningitis, and bloodstream infections.

18 services18 patients

Smoking and tobacco use intensive counseling, 4-10 minutes 99406

This service provides brief, intensive counseling (4-10 minutes) to support you in quitting smoking or tobacco use. It involves discussing the risks of tobacco use, benefits of quitting, and strategies to help you stop. It's a critical step towards a healthier lifestyle.

15 services14 patients

New patient office or other outpatient visit, 30-44 minutes 99203

This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.

11 services11 patients

Hospital Affiliations CMS Care Compare 2

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

Henry Ford Macomb Hospital

Acute Care Hospitals · Clinton Township, MI

2/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number230047

Location15855 Nineteen Mile RdClinton Township, MI 48038 · Macomb County

Emergency services Birthing friendly

Mclaren Port Huron

Acute Care Hospitals · Port Huron, MI

1/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number230216

Location1221 Pine Grove AvePort Huron, MI 48060 · St. Clair County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 48014 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

$84.74 typical visit price

range $54.34 – $166.68

Typical copayment $21.18 (range $13.58 – $41.67)

Most-billed visit code 99203

Established Patient

$96.44 typical visit price

range $17.09 – $135.40

Typical copayment $24.11 (range $4.27 – $33.85)

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.

82.67/100

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

Scored as part of a group practice

Quality

88.95

Promoting Interoperability

Improvement Activities

Cost

79.97

Reported Quality Measures

Breast Cancer Screening

71%99 patients1/55-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.

Referred Medical Equipment & Supplies CMS DME claims 13

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

10 suppliers69 claims241 services$6.24 avg. paid by Medicare

Normal, low and high calibrator solution / chips A4256

DME-Other DME · category DE000N

3 suppliers25 claims25 services$2.81 avg. paid by Medicare

Spring-powered device for lancet, each A4258

DME-Other DME · category DE000N

3 suppliers11 claims11 services$1.83 avg. paid by Medicare

Lancets, per box of 100 A4259

DME-Medical/Surgical Supplies · category DA000N

7 suppliers40 claims61 services$1.15 avg. paid by Medicare

Headgear used with positive airway pressure device A7035

DME-Other DME · category DE001N

5 suppliers11 claims11 services$14.56 avg. paid by Medicare

Filter, disposable, used with positive airway pressure device A7038

DME-Other DME · category DE001N

5 suppliers13 claims78 services$1.57 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 2

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

DR. NORBERT E CONRAD D.O.

Family Medicine

117 S MAIN ST
CAPAC, MI 48014

St. Clair County (810) 395-4840

FAMILY FIRST HEALTH CARE CAPAC PLLC

Family Medicine

117 S MAIN ST
CAPAC, MI 48014

St. Clair County (810) 395-4840

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 Loren Decarlo's NPI number?

The NPI number for Loren Decarlo is 1629003462. It was assigned to this individual provider in the NPPES registry on July 11, 2006.

Where is Loren Decarlo located?

Loren Decarlo practices at 117 S Main St, Capac, MI 48014. The listed phone number is (810) 395-4840.

What is Loren Decarlo's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Loren Decarlo enrolled in Medicare?

Yes. Loren Decarlo 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 Loren Decarlo accept?

Health plans from Blue Care Network of Michigan, Blue Cross Blue Shield of Michigan Mutual Insurance Company, McLaren Health Plan Community and Priority Health list Loren Decarlo 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 Loren Decarlo affiliated with any hospitals?

According to CMS data, Loren Decarlo is affiliated with Henry Ford Macomb Hospital and Mclaren Port Huron.

When was this NPI record last updated?

The NPPES record for Loren Decarlo was last updated on March 21, 2011. NPI Profile syncs with the weekly NPPES data releases published by CMS.