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DR. THOMAS J CARTER DO, PHD
NPI 1649464439
Family Medicine in Wheatfield, IN

Active since September 05, 2007PECOS EnrolledAccepts Medicare Assignment
69.86/100
CMS Quality Rating
3988 W STATE ROAD 10, WHEATFIELD, IN 46392(219) 987-3581(219) 987-7137 Get Directions Write a Review

NPPES record last updated: January 27, 2026. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jan 27, 2026, Oct 30, 2023, Sep 30, 2015 (3 updates tracked since 2015).

About Dr. Thomas J Carter Do, Phd NPPES

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

DR. THOMAS J CARTER DO, PHD (NPI 1649464439) is an individual family medicine provider in Wheatfield, Indiana, licensed in Indiana (02008626A) and active in the NPI registry since September 2007. He is enrolled in Medicare PECOS, is affiliated with Northwest Health-la Porte, and is a graduate of Other (2005).

NPPES Registry Identity

NPI1649464439
Entity TypeIndividualMale
Primary Taxonomy207Q00000X
Provider Legal NameDR. THOMAS J CARTERCredential: DO, PHD
Location Address3988 W STATE ROAD 10Wheatfield, IN 46392-9251
Mailing Address650 Dickinson Rd Ste ZChesterton, IN 46304-3387
Phone(219) 987-3581
Fax(219) 987-7137
Sole ProprietorYes
Medical School CMSOtherGraduated 2005
Enumeration DateSeptember 5, 2007
Last NPPES UpdateJanuary 27, 20263 updates tracked since enumeration
NPPES CertifiedJanuary 27, 2026
✔ NPI 1649464439 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
Licenses✔ Licensed in IN · 02008626A✔ Licensed in CO · DR.0049159
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.
Also ListedGeneral PracticeTaxonomy 208D00000X · License 49159 (CO)
3988 W STATE ROAD 10, Wheatfield, IN 46392
Open in Google Maps ↗

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield.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. Thomas J Carter Do, Phd 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 ID7012084247
PECOS Enrollment IDI20101028001510, I20250923000147
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 2

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.
32 services20 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.
25 services18 patients

Hospital Affiliations CMS Care Compare 4

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

Northwest Health-La Porte

Acute Care Hospitals · La Porte, IN
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number150006
Location1331 State StreetLa Porte, IN 46350 · La Porte County
Emergency services Birthing friendly

Northwest Health - Porter

Acute Care Hospitals · Valparaiso, IN
3/5 CMS rating
OwnershipProprietary
CMS Certification Number150035
Location85 East Us Hwy 6Valparaiso, IN 46383 · Porter County
Emergency services Birthing friendly

Franciscan Health Crown Point

Acute Care Hospitals · Crown Point, IN
2/5 CMS rating
OwnershipVoluntary non-profit - Church
CMS Certification Number150126
Location12750 Saint Francis DriveCrown Point, IN 46307 · Lake County
Emergency services Birthing friendly

Franciscan Health Rensselaer, Inc

Critical Access Hospitals · Rensselaer, IN
OwnershipVoluntary non-profit - Private
CMS Certification Number151324
Location1104 E Grace StRensselaer, IN 47978 · Jasper County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 46392 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
$82.04 typical visit price
range $53.07 – $161.76
Typical copayment $20.51 (range $13.26 – $40.44)
Most-billed visit code 99203
Established Patient
$94.22 typical visit price
range $16.93 – $132.22
Typical copayment $23.55 (range $4.23 – $33.05)
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.

69.86/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality77.04
Promoting Interoperability95
Improvement Activities40
Cost15.83

Referred Medical Equipment & Supplies CMS DME claims 2

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

Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing E0431
DME-Oxygen and Supplies · category DC000N
3 suppliers16 claims19 services$17.23 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
3 suppliers19 claims20 services$113.85 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 3

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

TAMI CLINKENBEARD NP
Nurse Practitioner (Family)
3988 W STATE ROAD 10
WHEATFIELD, IN 46392
Jasper County (219) 987-3581
DAVID VANDERLUGT M.D.
Family Medicine
3988 W STATE ROAD 10
WHEATFIELD, IN 46392
Jasper County (219) 987-3581
MALLORY HANEWICH FNP-C
Nurse Practitioner
3988 W STATE ROAD 10
WHEATFIELD, IN 46392
Jasper County (219) 987-3581

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 Thomas Carter's NPI number?

The NPI number for Thomas Carter is 1649464439. It was assigned to this individual provider in the NPPES registry on September 5, 2007.

Where is Thomas Carter located?

Thomas Carter practices at 3988 W State Road 10, Wheatfield, IN 46392. The listed phone number is (219) 987-3581.

What is Thomas Carter's specialty?

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

Is Thomas Carter enrolled in Medicare?

Yes. Thomas Carter 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 Thomas Carter accept?

Health plans from Anthem Blue Cross and Blue Shield list Thomas Carter 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 Thomas Carter affiliated with any hospitals?

According to CMS data, Thomas Carter is affiliated with Northwest Health-La Porte, Northwest Health - Porter, Franciscan Health Crown Point and Franciscan Health Rensselaer, Inc.

When was this NPI record last updated?

The NPPES record for Thomas Carter was last updated on January 27, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 months 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.