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TONYA M CARTER CNP
NPI 1720218654
Nurse Practitioner - Family in Columbus, OH

Active since July 27, 2009PECOS EnrolledAccepts Medicare Assignment
410 W 10TH AVE, COLUMBUS, OH 43210(614) 293-8000(614) 473-0722 Get Directions Write a Review

NPPES record last updated: July 31, 2021. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Jul 31, 2021, Aug 9, 2016 (2 updates tracked since 2016).

About Tonya M Carter Cnp NPPES

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

TONYA M CARTER CNP (NPI 1720218654) is an individual family provider in Columbus, Ohio, licensed in Ohio (APRN.CNP.10807) and active in the NPI registry since July 2009. She is enrolled in Medicare PECOS, is affiliated with Riverside Methodist Hospital, and is a graduate of Other (2017).

NPPES Registry Identity

NPI1720218654
Entity TypeIndividualFemale
Primary Taxonomy363LF0000X
Provider Legal NameTONYA M CARTERCredential: CNP
Location Address410 W 10TH AVEColumbus, OH 43210-1240
Mailing Address2489 Stelzer Rd, Suite 101Columbus, OH 43219-3129 · (614) 473-1300 · Fax (614) 473-0722
Phone(614) 293-8000
Fax(614) 473-0722
Sole ProprietorYes
Medical School CMSOtherGraduated 2017
Enumeration DateJuly 27, 2009
Last NPPES UpdateJuly 31, 20212 updates tracked since enumeration
NPPES CertifiedJuly 31, 2021
✔ NPI 1720218654 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
License✔ Licensed in OH · APRN.CNP.10807
410 W 10TH AVE, Columbus, OH 43210
Open in Google Maps ↗

Other Identifiers 1

Medicaid3012046OH

Accepted Insurance

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

Tonya M Carter Cnp 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 ID6002952876
PECOS Enrollment IDI20091008000075
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 11

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.
129 services72 patients
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.
72 services59 patients
Annual depression screening, 5 to 15 minutes G0444
An annual depression screening is a short, routine evaluation to check for signs of depression. It involves answering a series of questions about your feelings, thoughts, and behaviors. The process takes about 15 minutes and helps detect depression early for better management.
55 services55 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.
52 services52 patients
Management using the results of remote vital sign monitoring per calendar month, each additional 20 minutes 99458
This service involves analyzing your vital signs, like heart rate and blood pressure, remotely collected over a month. Each additional 20 minutes spent on management refers to extra time spent reviewing, interpreting your data, and planning your care. It's a critical part of ensuring your wellbeing.
50 services11 patients
Chronic care management services for two or more chronic conditions, additional 20 minutes of clinical staff time directed by health care professional, per calendar month 99439
Chronic Care Management services involve regular check-ins with healthcare professionals to manage two or more chronic conditions. It includes an additional 20 minutes of clinical staff time per month, directed by a healthcare professional, to ensure optimal health management.
47 services14 patients

Hospital Affiliations CMS Care Compare 2

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

Riverside Methodist Hospital

Acute Care Hospitals · Columbus, OH
5/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number360006
Location3535 Olentangy River RdColumbus, OH 43214 · Franklin County
Emergency services Birthing friendly

Grant Medical Center

Acute Care Hospitals · Columbus, OH
3/5 CMS rating
OwnershipVoluntary non-profit - Church
CMS Certification Number360017
Location111 South Grant AvenueColumbus, OH 43215 · Franklin County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 43210 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
$84.72 typical visit price
range $54.34 – $166.65
Typical copayment $21.18 (range $13.58 – $41.66)
Most-billed visit code 99203
Established Patient
$96.44 typical visit price
range $17.10 – $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.

Other Providers at the Same Location NPPES 20

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

LARA L. VANHUYSEN C.R.N.A.
Nurse Anesthetist, Certified Registered
410 W 10TH AVE
COLUMBUS, OH 43210
Franklin County (614) 293-8487
LAUREN TALANDA-FATH SOUTHERLAND M.D.
Emergency Medicine
410 W 10TH AVE, EMERGENCY DEPARTMENT
COLUMBUS, OH 43210
Franklin County (614) 293-8305
RAFAL KOPANCZYK DO
Anesthesiology
410 W 10TH AVE
COLUMBUS, OH 43210
Franklin County (614) 293-8487
RACHEL MARIE ASHWORTH CRNA
Nurse Anesthetist, Certified Registered
410 W 10TH AVE
COLUMBUS, OH 43210
Franklin County (614) 293-8487
ADAM T. RAMEY MD
Hospitalist
410 W 10TH AVE
COLUMBUS, OH 43210
Franklin County (614) 293-7499
DR. AMY ELIZABETH SCHULTZ PHARM.D.
Pharmacist
410 W 10TH AVE, 368 DOAN HALL
COLUMBUS, OH 43210
Franklin County (614) 366-6754
MAYA HARARY MD
Neurological Surgery
410 W 10TH AVE
COLUMBUS, OH 43210
Franklin County (614) 293-8714
NICOLE L HESS APRN-CNP
Nurse Practitioner
410 W 10TH AVE
COLUMBUS, OH 43210
Franklin County (614) 293-9600

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 Tonya Carter's NPI number?

The NPI number for Tonya Carter is 1720218654. It was assigned to this individual provider in the NPPES registry on July 27, 2009.

Where is Tonya Carter located?

Tonya Carter practices at 410 W 10th Ave, Columbus, OH 43210. The listed phone number is (614) 293-8000.

What is Tonya Carter's specialty?

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

Is Tonya Carter enrolled in Medicare?

Yes. Tonya 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 Tonya Carter accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Meridian, Anthem Blue Cross and Blue Shield and CareSource and 2 other insurers list Tonya 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 Tonya Carter affiliated with any hospitals?

According to CMS data, Tonya Carter is affiliated with Riverside Methodist Hospital and Grant Medical Center.

When was this NPI record last updated?

The NPPES record for Tonya Carter was last updated on July 31, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.