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MR. WILLIAM MICHAEL CARTER MD
NPI 1720013873
Family Medicine in Tompkinsville, KY

Active since July 11, 2006PECOS EnrolledAccepts Medicare Assignment
606 N MAIN STREET, TOMPKINSVILLE, KY 42167(270) 487-6161(270) 487-8009 Get Directions Write a Review

NPPES record last updated: June 29, 2010. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Mr. William Michael Carter Md NPPES

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

MR. WILLIAM MICHAEL CARTER MD (NPI 1720013873) is an individual family medicine provider in Tompkinsville, Kentucky, licensed in Kentucky (22770) and active in the NPI registry since July 2006. He is enrolled in Medicare PECOS, is affiliated with T J Samson Community Hospital, and is a graduate of University Of Louisville School Of Medicine (1982).

NPPES Registry Identity

NPI1720013873
Entity TypeIndividualMale
Primary Taxonomy207Q00000X
Provider Legal NameMR. WILLIAM MICHAEL CARTERCredential: MD
Location Address606 N MAIN STREETTompkinsville, KY 42167
Mailing AddressPo Box 277, 606 N Main StreetTompkinsville, KY 42167 · (270) 487-6161 · Fax (270) 487-8009
Phone(270) 487-6161
Fax(270) 487-8009
Sole ProprietorNo
Medical School CMSUniversity Of Louisville School Of MedicineGraduated 1982
Enumeration DateJuly 11, 2006
Last NPPES UpdateJune 29, 2010
✔ NPI 1720013873 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in KY · 22770
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.
606 N MAIN STREET, Tompkinsville, KY 42167
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Other Names 1

Professional Name (2)W Michael Carter Md

Other Identifiers 4

Medicare UPINC75266
Medicaid64227705KY
Medicare ID-Type Unspecified3872183TN
Medicare ID-Type Unspecified1404701KY

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter Health, Ambetter of Tennessee and more.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

Mr. William Michael Carter Md 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 ID6002995891
PECOS Enrollment IDI20080505000768, I20100915000860
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 William Carter reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Monroe Medical Foundation, Inc.
Same address
Family Medicine
604 N MAIN ST
Tompkinsville, KY 42167
  • Reassigned Medicare billing, Kentucky enrollment
  • 42 clinicians in this Medicare group
NPI 1083854434 (270) 487-9231

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 7

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.

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes 99232
Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.
253 services89 patients
Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes 99222
Initial hospital inpatient care is a service where a healthcare provider spends about 50 minutes per day overseeing your care while you're admitted in the hospital. This includes reviewing your health status, planning your treatment, and ensuring your safety and comfort.
120 services63 patients
Hospital discharge day management, 30 minutes or less 99238
Hospital discharge day management of 30 minutes or less includes finalizing your treatment, discussing your progress, and planning after-care at home. It ensures you're ready to leave the hospital and continue recovery safely.
86 services56 patients
Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, 20 minutes or more 99308
A follow-up nursing facility visit per day is a daily check-up service provided by healthcare professionals. It lasts around 15 minutes and involves assessing your health status, monitoring your recovery progress, and addressing any concerns you may have about your health or treatment.
67 services19 patients
Physician or allowed practitioner re-certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians a G0179
This procedure involves a doctor or approved practitioner reviewing your health status and re-certifying your need for Medicare-covered home health services. It includes communication with the home health agency and assessment of your health reports, even when you're not physically present.
24 services12 patients
Physician or allowed practitioner certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians and G0180
This is a service where a doctor or authorized practitioner certifies that you require Medicare-covered home health services. They will communicate with the home health agency and review reports on your health status to ensure you receive appropriate care. This does not involve an in-person visit.
19 services17 patients

Hospital Affiliations CMS Care Compare 2

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

T J Samson Community Hospital

Acute Care Hospitals · Glasgow, KY
3/5 CMS rating
OwnershipVoluntary non-profit - Other
CMS Certification Number180017
Location1301 North Race StreetGlasgow, KY 42141 · Barren County
Emergency services Birthing friendly

Monroe County Medical Center

Acute Care Hospitals · Tompkinsville, KY
1/5 CMS rating
OwnershipVoluntary non-profit - Other
CMS Certification Number180105
Location529 Capp Harlan RoadTompkinsville, KY 42167 · Monroe County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 42167 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
$82.24 typical visit price
range $52.76 – $162.27
Typical copayment $20.56 (range $13.19 – $40.56)
Most-billed visit code 99203
Established Patient
$93.94 typical visit price
range $16.53 – $131.99
Typical copayment $23.48 (range $4.13 – $32.99)
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.

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
5 suppliers52 claims121 services$5.45 avg. paid by Medicare
Lancets, per box of 100 A4259
DME-Medical/Surgical Supplies · category DA000N
4 suppliers23 claims29 services$0.78 avg. paid by Medicare
For diabetics only, fitting (including follow-up), custom preparation and supply of off-the-shelf depth-inlay shoe manufactured to accommodate multi-density insert(s), per shoe A5500
DME-Orthotic Devices · category DF000N
4 suppliers11 claims22 services$54.18 avg. paid by Medicare
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress E0260
DME-Hospital Beds · category DB000N
2 suppliers26 claims26 services$65.50 avg. paid by Medicare
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing E0431
DME-Oxygen and Supplies · category DC000N
3 suppliers31 claims31 services$18.53 avg. paid by Medicare
Nebulizer, with compressor E0570
DME-Other DME · category DE000N
2 suppliers77 claims82 services$7.60 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

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 William Carter's NPI number?

The NPI number for William Carter is 1720013873. It was assigned to this individual provider in the NPPES registry on July 11, 2006. The provider is also known as W Michael Carter MD.

Where is William Carter located?

William Carter practices at 606 N Main Street, Tompkinsville, KY 42167. The listed phone number is (270) 487-6161.

What is William Carter's specialty?

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

Is William Carter enrolled in Medicare?

Yes. William 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.

Which organization bills Medicare for William Carter's services?

According to the CMS Revalidation Reassignment List (October 2026 release), William Carter reassigns Medicare benefits to Monroe Medical Foundation, Inc. (Tompkinsville, KY). 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 William Carter's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does William Carter accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter of Tennessee and Anthem Blue Cross and Blue Shield list William 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 William Carter affiliated with any hospitals?

According to CMS data, William Carter is affiliated with T J Samson Community Hospital and Monroe County Medical Center.

When was this NPI record last updated?

The NPPES record for William Carter was last updated on June 29, 2010. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 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.