MARGARET CARTER
NPI 1790009215
Otolaryngology in San Jose, CA

Active since March 26, 2010PECOS EnrolledAccepts Medicare Assignment
87.26/100
CMS Quality Rating
6060 HELLYER AVE, SUITE 150, SAN JOSE, CA 95138(408) 227-6300(408) 227-6314 Get Directions Write a Review

NPPES record last updated: July 21, 2015. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Margaret Carter NPPES

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

MARGARET CARTER (NPI 1790009215) is an individual otolaryngology provider in San Jose, California, licensed in California (A136997) and active in the NPI registry since March 2010. She is enrolled in Medicare PECOS and is a graduate of Loyola University Of Chicago, Stritch School Of Medicine (2010).

NPPES Registry Identity

NPI1790009215
Entity TypeIndividualFemale
Primary Taxonomy207Y00000X
Provider Legal NameMARGARET CARTER
Location Address6060 HELLYER AVE, SUITE 150San Jose, CA 95138-1046
Mailing Address6060 Hellyer Ave, Suite 150San Jose, CA 95138-1046 · (408) 227-6300 · Fax (408) 227-6314
Fax(408) 227-6314
Sole ProprietorYes
Medical School CMSLoyola University Of Chicago, Stritch School Of MedicineGraduated 2010
Enumeration DateMarch 26, 2010
Last NPPES UpdateJuly 21, 2015
NPI 1790009215 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyOtolaryngologyAllopathic & Osteopathic Physicians
Taxonomy Code207Y00000X
License Licensed in CA · A136997
Definition
An otolaryngologist-head and neck surgeon provides comprehensive medical and surgical care for patients with diseases and disorders that affect the ears, nose, throat, the respiratory and upper alimentary systems and related structures of the head and neck. An otolaryngologist diagnoses and provides medical and/or surgical therapy or prevention of diseases, allergies, neoplasms, deformities, disorders and/or injuries of the ears, nose, sinuses, throat, respiratory and upper alimentary systems, face, jaws and the other head and neck systems. Head and neck oncology, facial plastic and reconstructive surgery and the treatment of disorders of hearing and voice are fundamental areas of expertise.
6060 HELLYER AVE, San Jose, CA 95138

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

Margaret Carter 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 ID1557521986
PECOS Enrollment IDI20150803001993
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.

Diagnostic exam of voice box using a flexible endoscope 31575
This procedure involves a doctor examining your voice box using a flexible endoscope, a thin tube with a light and camera. It's inserted through your nose or mouth to visualize your throat area. It helps detect any abnormalities in your voice box, ensuring optimal vocal health.
198 services167 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.
156 services107 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.
132 services111 patients
New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203
This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.
76 services76 patients
Removal of impacted ear wax 69210
Impacted ear wax removal is a safe procedure to clear blockages in the ear canal caused by hardened ear wax. A healthcare professional uses specialized tools or a gentle irrigation method to loosen and remove the wax, improving hearing and alleviating discomfort.
73 services53 patients
Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more 99215
This service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.
39 services35 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 95138 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
$156.67 typical visit price
range $70.37 – $206.04
Typical copayment $39.16 (range $17.59 – $51.51)
Most-billed visit code 99204
Established Patient
$86.56 typical visit price
range $23.96 – $169.60
Typical copayment $21.64 (range $5.99 – $42.40)
Most-billed visit code 99213
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.

87.26/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored through an Alternative Payment Model
Quality82.97
Promoting Interoperability85.91
Improvement Activities40

Reported Quality Measures

Appropriate Use of DXA Scans in Women Under 65 Years Who Do Not Meet the Risk Factor Profile for Osteoporotic Fracture
Lower rates are better for this measure.
1%95 patients
Breast Cancer Screening
36%264 patients2/55-star benchmark: 93%
Cervical Cancer Screening
17%369 patients1/55-star benchmark: 98%
Childhood Immunization Status
62%34 patients
Chlamydia Screening for Women
9%23 patients
Colorectal Cancer Screening
25%558 patients2/55-star benchmark: 88%
Controlling High Blood Pressure
63%111 patients3/55-star benchmark: 91%
Diabetes: Eye Exam
17%23 patients1/55-star benchmark: 100%
Diabetes: Hemoglobin A1c (HbA1c) Poor Control (>9%)
Lower rates are better for this measure.
39%23 patients3/55-star benchmark: 91%
Documentation of Current Medications in the Medical Record
96%1,936 patients4/55-star benchmark: 100%
e-Prescribing
100%608 patients5/55-star benchmark: 100%
Falls: Screening for Future Fall Risk
16%354 patients1/55-star benchmark: 100%
HIV Screening
11%816 patients1/55-star benchmark: 60%
Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan
40%1,104 patients2/55-star benchmark: 98%
Preventive Care and Screening: Screening for Depression and Follow-Up Plan
6%1,104 patients1/55-star benchmark: 97%
Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention
Patients screened: 64% · 581 patients
62%581 patients
Provide Patients Electronic Access to Their Health Information
74%571 patients3/55-star benchmark: 100%
Statin Therapy for the Prevention and Treatment of Cardiovascular Disease
73%187 patients3/55-star benchmark: 91%
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 5

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

Audiologist
6060 HELLYER AVE, SUITE 150
SAN JOSE, CA 95138
Audiologist
6060 HELLYER AVE, SUITE 150
SAN JOSE, CA 95138
Otolaryngology
6060 HELLYER AVE, SUITE 150
SAN JOSE, CA 95138
Audiologist
6060 HELLYER AVE, SUITE 150
SAN JOSE, CA 95138
Otolaryngology
6060 HELLYER AVE
SAN JOSE, CA 95138

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 Margaret Carter's NPI number?

The NPI number for Margaret Carter is 1790009215. It was assigned to this individual provider in the NPPES registry on March 26, 2010.

Where is Margaret Carter located?

Margaret Carter practices at 6060 Hellyer Ave Suite 150, San Jose, CA 95138. The listed phone number is (408) 227-6300.

What is Margaret Carter's specialty?

The primary specialty registered for this NPI is Otolaryngology with taxonomy code 207Y00000X.

Is Margaret Carter enrolled in Medicare?

Yes. Margaret 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.

When was this NPI record last updated?

The NPPES record for Margaret Carter was last updated on July 21, 2015. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 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.