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MS. CARMEN E. ADDINGTON CNS
NPI 1639625965
Nurse Practitioner - Family in Austin, TX

Active since August 28, 2016PECOS EnrolledAccepts Medicare Assignment
83.36/100
CMS Quality Rating
6500 N MOPAC EXPY, BLDG 3, STE 200, AUSTIN, TX 78731(512) 458-8400(512) 458-8593 Get Directions Write a Review

NPPES record last updated: August 29, 2016. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Aug 29, 2016, Aug 28, 2016 (2 updates tracked since 2016).

About Ms. Carmen E. Addington Cns NPPES

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

MS. CARMEN E. ADDINGTON CNS (NPI 1639625965) is an individual family provider in Austin, Texas, licensed in Texas (AP131244) and active in the NPI registry since August 2016. She is enrolled in Medicare PECOS and is a graduate of Other (2016).

NPPES Registry Identity

NPI1639625965
Entity TypeIndividualFemale
Primary Taxonomy363LF0000X
Provider Legal NameMS. CARMEN E. ADDINGTONCredential: CNS
Location Address6500 N MOPAC EXPY, BLDG 3, STE 200Austin, TX 78731
Mailing Address6500 N Mopac Expy, Bldg 3, Ste 200Austin, TX 78731 · (512) 458-8400 · Fax (512) 458-8593
Phone(512) 458-8400
Fax(512) 458-8593
Sole ProprietorNo
Medical School CMSOtherGraduated 2016
Enumeration DateAugust 28, 2016
Last NPPES UpdateAugust 29, 20162 updates tracked since enumeration
✔ NPI 1639625965 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
License✔ Licensed in TX · AP131244
Also ListedRegistered NurseTaxonomy 163W00000X · License 763846 (TX)
6500 N MOPAC EXPY, Austin, TX 78731
Open in Google Maps ↗

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of Texas, Moda Health Plan, Inc..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

Ms. Carmen E. Addington Cns 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 ID6002104023
PECOS Enrollment IDI20161006002056
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 5

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.
386 services273 patients
Continuous monitoring of blood sugar level in tissue fluid using sensor under skin with interpretation and report 95251
This procedure involves placing a small sensor under your skin to continuously monitor your blood sugar levels in tissue fluid. The data is interpreted and a report is generated to help manage your diabetes more effectively.
143 services87 patients
Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more 99215
This service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.
43 services31 patients
Ultrasound scan of head and neck soft tissue 76536
An ultrasound scan of the head and neck soft tissue is a non-invasive procedure that uses sound waves to create images of the soft tissues in these areas. It helps identify any abnormalities or issues, such as tumors, cysts, or infections. It's painless and doesn't involve radiation.
12 services12 patients
New patient office or other outpatient visit with a high level of medical decision making, if using time, 60 minutes or more 99205
This is a first-time patient visit where a healthcare professional spends 60-74 minutes with you. It involves a comprehensive evaluation, including your medical history and current health condition. They'll also advise on preventive health measures and formulate a treatment plan if needed.
11 services11 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 78731 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
$89.03 typical visit price
range $57.88 – $174.00
Typical copayment $22.25 (range $14.47 – $43.50)
Most-billed visit code 99203
Established Patient
$101.65 typical visit price
range $18.88 – $142.23
Typical copayment $25.41 (range $4.72 – $35.55)
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.

83.36/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality76.84
Promoting Interoperability87
Improvement Activities40

Referred Medical Equipment & Supplies CMS DME claims 8

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

Supplies for maintenance of insulin infusion catheter, per week A4224
DME-Other DME · category DE017N
3 suppliers17 claims211 services$18.60 avg. paid by Medicare
Supplies for external insulin infusion pump, syringe type cartridge, sterile, each A4225
DME-Other DME · category DE017N
3 suppliers17 claims510 services$2.37 avg. paid by Medicare
Supply allowance for adjunctive continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service A4238
DME-Medical/Surgical Supplies · category DA000N
2 suppliers11 claims11 services$170.13 avg. paid by Medicare
Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253
DME-Other DME · category DE017N
33 suppliers73 claims297 services$6.19 avg. paid by Medicare
Lancets, per box of 100 A4259
DME-Medical/Surgical Supplies · category DA000N
11 suppliers24 claims55 services$1.10 avg. paid by Medicare
External ambulatory infusion pump, insulin E0784
DME-Other DME · category DE017N
2 suppliers36 claims36 services$303.60 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 7

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

EMILY HANSELMAN RD
Dietitian, Registered
6500 N MOPAC EXPY, BLDG III, STE 220
AUSTIN, TX 78731
Travis County (512) 383-4500
LAUREN MARY KELL RN
Registered Nurse (Women's Health Care, Ambulatory)
6500 N MOPAC EXPY
AUSTIN, TX 78731
Travis County (512) 451-0149
DR. LUKE AARON JOHNSON DDS
Dentist (General Practice)
6500 N MOPAC EXPY, BLDG 2, STE 2103
AUSTIN, TX 78731
Travis County (512) 346-3427
PERFORMANCE WELLNESS PHYSICAL THERAPY CENTER
Physical Therapist
6500 N MOPAC EXPY, BLDG. 3, STE. 101
AUSTIN, TX 78731
Travis County (512) 491-7772
MRS. KENDRA ANN GOTTLIEB NP
Nurse Practitioner
6500 N MOPAC EXPY, BLDG 3 STE 200
AUSTIN, TX 78731
Travis County (512) 458-8400
ASHLEY MURCHISON DUFOUR
Physician Assistant (Medical)
6500 N MOPAC EXPY, BUILDING 2, SUITE 2102
AUSTIN, TX 78731
Travis County (512) 476-6060
DR. JONATHAN RYAN SHANER D.C.
Chiropractor
6500 N MOPAC EXPY, BLDG. 3, SUITE 101
AUSTIN, TX 78731
Travis County (512) 491-7772

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 Carmen Addington's NPI number?

The NPI number for Carmen Addington is 1639625965. It was assigned to this individual provider in the NPPES registry on August 28, 2016.

Where is Carmen Addington located?

Carmen Addington practices at 6500 N Mopac Expy Bldg 3, Ste 200, Austin, TX 78731. The listed phone number is (512) 458-8400.

What is Carmen Addington's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Is Carmen Addington enrolled in Medicare?

Yes. Carmen Addington 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 Carmen Addington accept?

Health plans from Blue Cross and Blue Shield of Texas and Moda Health Plan, Inc. list Carmen Addington 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 Carmen Addington was last updated on August 29, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 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.