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CARL R JONES DO
NPI 1760478838
Internal Medicine - Gastroenterology in Nacogdoches, TX

Active since September 23, 2005PECOS EnrolledAccepts Medicare Assignment
95.5/100
CMS Quality Rating
522 RUSSELL BLVD, NACOGDOCHES, TX 75965(936) 569-2000(936) 569-2002 Get Directions Write a Review

NPPES record last updated: July 21, 2022. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Jul 21, 2022, Feb 9, 2021, Mar 17, 2018 and 1 more (4 updates tracked since 2017).

About Carl R Jones Do NPPES

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

CARL R JONES DO (NPI 1760478838) is an individual gastroenterology provider in Nacogdoches, Texas, licensed in Texas (P2129) and active in the NPI registry since September 2005. He is enrolled in Medicare PECOS, is affiliated with Chi St Lukes Health Memorial Lufkin, and is a graduate of West Virginia School Of Osteopathic Medicine (1992).

NPPES Registry Identity

NPI1760478838
Entity TypeIndividualMale
Primary Taxonomy207RG0100X
Provider Legal NameCARL R JONESCredential: DO
Location Address522 RUSSELL BLVDNacogdoches, TX 75965-1244
Mailing Address522 Russell BlvdNacogdoches, TX 75965-1244 · (936) 569-2000 · Fax (936) 569-2002
Phone(936) 569-2000
Fax(936) 569-2002
Sole ProprietorNo
Medical School CMSWest Virginia School Of Osteopathic MedicineGraduated 1992
Enumeration DateSeptember 23, 2005
Last NPPES UpdateJuly 21, 20224 updates tracked since enumeration
NPPES CertifiedFebruary 9, 2021
✔ NPI 1760478838 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · GastroenterologyAllopathic & Osteopathic Physicians
Taxonomy Code207RG0100X
License✔ Licensed in TX · P2129
Definition
An internist who specializes in diagnosis and treatment of diseases of the digestive organs including the stomach, bowels, liver and gallbladder. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using endoscopes to visualize internal organs.
522 RUSSELL BLVD, Nacogdoches, TX 75965
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of Texas.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

Carl R Jones 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 ID5991748063
PECOS Enrollment IDI20120824000750
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.
480 services374 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.
375 services328 patients
New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204
This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.
312 services312 patients
Biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope 43239
This procedure involves using a thin, flexible tube with a light and camera, known as an endoscope, to examine the esophagus, stomach, and upper part of the small intestine. Small tissue samples are taken for further examination to help diagnose various conditions.
128 services125 patients
Removal of polyps or growths of large bowel using a flexible endoscope with electrical cautery 45384
This procedure involves using a flexible tube with a camera, called an endoscope, to view the large intestine. If any abnormal growths or polyps are found, they are removed with an electrically-heated instrument. This is a common way to prevent bowel issues.
68 services68 patients
Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes 99223
Initial hospital inpatient care per day, typically 70 minutes, refers to the daily medical service provided to patients admitted to the hospital. This includes a comprehensive evaluation, diagnosis, treatment plan, and monitoring of your health condition. It ensures your well-being during your hospital stay.
60 services56 patients

Hospital Affiliations CMS Care Compare 5

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

Chi St Lukes Health Memorial Lufkin

Acute Care Hospitals · Lufkin, TX
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number450211
Location1201 West Frank StreetLufkin, TX 75901 · Angelina County
Emergency services Birthing friendly

Woodland Heights Medical Center

Acute Care Hospitals · Lufkin, TX
4/5 CMS rating
OwnershipProprietary
CMS Certification Number450484
Location505 South John Redditt DriveLufkin, TX 75904 · Angelina County
Emergency services Birthing friendly

Nacogdoches Memorial Hospital

Acute Care Hospitals · Nacogdoches, TX
1/5 CMS rating
OwnershipProprietary
CMS Certification Number450508
Location1204 Mound StNacogdoches, TX 75961 · Nacogdoches County
Emergency services Birthing friendly

Nacogdoches Medical Center

Acute Care Hospitals · Nacogdoches, TX
2/5 CMS rating
OwnershipVoluntary non-profit - Other
CMS Certification Number450656
Location4920 NE Stallings DriveNacogdoches, TX 75965 · Nacogdoches County
Emergency services Birthing friendly

Sabine County Hospital

Critical Access Hospitals · Hemphill, TX
OwnershipProprietary
CMS Certification Number451361
LocationPO Box 750, 2301 Hwy 83 WHemphill, TX 75948 · Sabine County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 75965 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
$126.40 typical visit price
range $54.84 – $166.88
Typical copayment $31.60 (range $13.71 – $41.72)
Most-billed visit code 99204
Established Patient
$97.05 typical visit price
range $17.52 – $136.11
Typical copayment $24.26 (range $4.38 – $34.02)
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.

95.5/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Individually scored
Quality100
Improvement Activities40
Cost85

Reported Quality Measures

Advance Care Plan
100%1,217 patients5/55-star benchmark: 100%
Closing the Referral Loop: Receipt of Specialist Report
96%84 patients5/55-star benchmark: 87%
Colorectal Cancer Screening
100%1,364 patients5/55-star benchmark: 88%
Controlling High Blood Pressure
100%1,007 patients5/55-star benchmark: 91%
Documentation of Current Medications in the Medical Record
96%3,575 patients4/55-star benchmark: 100%
Falls: Screening for Future Fall Risk
100%1,126 patients5/55-star benchmark: 100%
Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan
98%2,158 patients5/55-star benchmark: 98%
Preventive Care and Screening: Screening for High Blood Pressure and Follow-Up Documented
20%1,993 patients2/55-star benchmark: 61%
Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention
Patients combinedPopulations: 100% · 915 patients
Patients screened: 100% · 915 patients
100%75 patients5/55-star benchmark: 100%
Statin Therapy for the Prevention and Treatment of Cardiovascular Disease
80%359 patients4/55-star benchmark: 91%
Use of High-Risk Medications in Older Adults
Lower rates are better for this measure.
Patients appropriateDiagnosis: 1% · 1,184 patients
Patients totalRate: 10% · 1,185 patients
10%1,185 patients4/55-star benchmark: 100%
Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

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.

NIELSEN UROLOGY
Urology
522 RUSSELL BLVD
NACOGDOCHES, TX 75965
Nacogdoches County (936) 564-3030
NACOGDOCHES GI CONSULTANTS PLLC
Internal Medicine (Gastroenterology)
522 RUSSELL BLVD
NACOGDOCHES, TX 75965
Nacogdoches County (936) 569-6449
NACOGDOCHES GASTROENTEROLOGY PLLC
Internal Medicine (Gastroenterology)
522 RUSSELL BLVD
NACOGDOCHES, TX 75965
Nacogdoches County (936) 569-2000

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 Carl Jones's NPI number?

The NPI number for Carl Jones is 1760478838. It was assigned to this individual provider in the NPPES registry on September 23, 2005.

Where is Carl Jones located?

Carl Jones practices at 522 Russell Blvd, Nacogdoches, TX 75965. The listed phone number is (936) 569-2000.

What is Carl Jones's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Gastroenterology, with taxonomy code 207RG0100X.

Is Carl Jones enrolled in Medicare?

Yes. Carl Jones 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 Carl Jones accept?

Health plans from Blue Cross and Blue Shield of Texas list Carl Jones 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 Carl Jones affiliated with any hospitals?

According to CMS data, Carl Jones is affiliated with Chi St Lukes Health Memorial Lufkin, Woodland Heights Medical Center, Nacogdoches Memorial Hospital, Nacogdoches Medical Center and Sabine County Hospital.

When was this NPI record last updated?

The NPPES record for Carl Jones was last updated on July 21, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.