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CLAUDIA J DUNCAN DO
NPI 1699877522
Family Medicine in Hurricane, WV

Active since September 01, 2006PECOS EnrolledAccepts Medicare Assignment
90.11/100
CMS Quality Rating
1209 HOSPITAL DRIVE, HURRICANE, WV 25526(304) 201-5165(304) 201-5167 Get Directions Write a Review

NPPES record last updated: October 25, 2007. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Claudia J Duncan Do NPPES

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

CLAUDIA J DUNCAN DO (NPI 1699877522) is an individual family medicine provider in Hurricane, West Virginia, licensed in West Virginia (1584) and active in the NPI registry since September 2006. She is enrolled in Medicare PECOS, is affiliated with Charleston Area Medical Center, and is a graduate of West Virginia School Of Osteopathic Medicine (1992).

NPPES Registry Identity

NPI1699877522
Entity TypeIndividualFemale
Primary Taxonomy207Q00000X
Provider Legal NameCLAUDIA J DUNCANCredential: DO
Location Address1209 HOSPITAL DRIVEHurricane, WV 25526-0000
Mailing Address1209 Hospital DriveHurricane, WV 25526-0000 · (304) 201-5165 · Fax (304) 201-5167
Phone(304) 201-5165
Fax(304) 201-5167
Sole ProprietorNo
Medical School CMSWest Virginia School Of Osteopathic MedicineGraduated 1992
Enumeration DateSeptember 1, 2006
Last NPPES UpdateOctober 25, 2007
✔ NPI 1699877522 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in WV · 1584
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.
1209 HOSPITAL DRIVE, Hurricane, WV 25526
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Other Identifiers 4

Medicare PIN4119021WV
Other001711250WV · Blue Cross Blue Shield
Medicare UPING62583WV
Medicaid5630469000WV

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include CareSource, Highmark Blue Cross Blue Shield West Virginia.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

Claudia J Duncan Do 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 ID3971407628
PECOS Enrollment IDI20031125000837
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 Reassignment

Medicare enrollment records show Claudia Duncan reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Charleston Area Medical Center, Inc.
19 mi
General Acute Care Hospital
501 MORRIS ST
Charleston, WV 25301
  • Reassigned Medicare billing, West Virginia enrollment
  • 1,511 clinicians in this Medicare group
NPI 1124248752 (304) 388-3939

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 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 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.
84 services80 patients
New patient office or other outpatient visit with straightforward medical decision making, if using time, 15 minutes or more 99202
This service involves an initial visit to the doctor's office or other outpatient setting. It typically lasts between 15-29 minutes. The doctor will review your medical history, conduct a physical examination, and discuss your health concerns. It's a chance to establish your health baseline and address any immediate medical issues.
31 services31 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.
22 services22 patients
Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more 99212
This is a routine check-up for patients who have previously seen the doctor. During this 10-19 minute visit, the doctor will review your health status, discuss any concerns, and manage ongoing treatments or medications. It's a chance to ensure your health is on track.
14 services14 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.
13 services13 patients

Hospital Affiliations CMS Care Compare

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

Charleston Area Medical Center

Acute Care Hospitals · Charleston, WV
1/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number510022
Location501 Morris StreetCharleston, WV 25301 · Kanawha County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 25526 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
$83.49 typical visit price
range $53.20 – $164.59
Typical copayment $20.87 (range $13.30 – $41.14)
Most-billed visit code 99203
Established Patient
$94.81 typical visit price
range $16.47 – $133.29
Typical copayment $23.70 (range $4.11 – $33.32)
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.

90.11/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored through an Alternative Payment Model
Quality66.96
Promoting Interoperability100
Improvement Activities40

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 Claudia Duncan's NPI number?

The NPI number for Claudia Duncan is 1699877522. It was assigned to this individual provider in the NPPES registry on September 1, 2006.

Where is Claudia Duncan located?

Claudia Duncan practices at 1209 Hospital Drive, Hurricane, WV 25526. The listed phone number is (304) 201-5165.

What is Claudia Duncan's specialty?

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

Is Claudia Duncan enrolled in Medicare?

Yes. Claudia Duncan 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 organization bills Medicare for Claudia Duncan's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Claudia Duncan reassigns Medicare benefits to Charleston Area Medical Center, Inc. (Charleston, WV). The 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 Claudia Duncan's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Claudia Duncan accept?

Health plans from CareSource and Highmark Blue Cross Blue Shield West Virginia list Claudia Duncan 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 Claudia Duncan affiliated with any hospitals?

According to CMS data, Claudia Duncan is affiliated with Charleston Area Medical Center.

When was this NPI record last updated?

The NPPES record for Claudia Duncan was last updated on October 25, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 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.