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CARL L FALCONE MD
NPI 1801954144
Otolaryngology in Concord, NH

Active since December 05, 2006PECOS Enrolled
81.9/100
CMS Quality Rating
60 COMMERCIAL ST STE 401, CONCORD, NH 03301(603) 789-9150(603) 227-7592 Get Directions Write a Review

NPPES record last updated: January 27, 2021. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jan 27, 2021, Jan 13, 2021, Dec 20, 2019 and 1 more (4 updates tracked since 2018).

About Carl L Falcone Md NPPES

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

CARL L FALCONE MD (NPI 1801954144) is an individual otolaryngology provider in Concord, New Hampshire, licensed in New Hampshire (19954) and active in the NPI registry since December 2006. He is enrolled in Medicare PECOS and maintains a secondary practice location in Pensacola.

NPPES Registry Identity

NPI1801954144
Entity TypeIndividualMale
Primary Taxonomy207Y00000X
Provider Legal NameCARL L FALCONECredential: MD
Location Address60 COMMERCIAL ST STE 401Concord, NH 03301-5096
Mailing Address60 Commercial St Ste 401Concord, NH 03301-5096 · (603) 789-9150 · Fax (603) 227-7592
Phone(603) 789-9150
Fax(603) 227-7592
Sole ProprietorNo
Enumeration DateDecember 5, 2006
Last NPPES UpdateJanuary 27, 20214 updates tracked since enumeration
NPPES CertifiedJanuary 27, 2021
✔ NPI 1801954144 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyOtolaryngologyAllopathic & Osteopathic Physicians
Taxonomy Code207Y00000X
License✔ Licensed in NH · 19954
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.
Also ListedOtolaryngology · Pediatric OtolaryngologyTaxonomy 207YP0228X · License ME134441 (FL)
60 COMMERCIAL ST STE 401, Concord, NH 03301
Open in Google Maps ↗

Secondary Practice Location 1

Location 15153 N 9th AvePensacola, FL 32504-8785 · Phone (850) 505-4700 · Fax (850) 505-4711

Other Identifiers 1

Medicaid024634500FL

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, AvMed, UnitedHealthcare.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Carl L Falcone Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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 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.

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.
65 services65 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.
49 services34 patients
Test to assess middle ear function 92567
A test to assess middle ear function, also known as an impedance audiometry, helps evaluate how well your middle ear works. It measures the movement of your eardrum in response to changes in air pressure. This can help identify issues like fluid build-up, ear infections, or eardrum perforations.
25 services25 patients
Comprehensive hearing and speech recognition test 92557
A comprehensive hearing and speech recognition test assesses your ability to hear and understand spoken words. It includes hearing tests to check for issues with sound perception and speech tests to evaluate your word recognition. It's a crucial step in identifying any hearing or speech problems.
22 services22 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.
20 services19 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 03301 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
$132.09 typical visit price
range $57.75 – $174.26
Typical copayment $33.02 (range $14.43 – $43.56)
Most-billed visit code 99204
Established Patient
$71.85 typical visit price
range $18.70 – $142.15
Typical copayment $17.96 (range $4.67 – $35.53)
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.

81.9/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality72.43
Promoting Interoperability100
Improvement Activities40
Cost59.59

Other Providers at the Same Location NPPES 4

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

STEPHANIE STRONG
Audiologist
60 COMMERCIAL ST STE 401
CONCORD, NH 03301
Merrimack County (603) 789-9150
JOHN H ROMANOW MD
Otolaryngology
60 COMMERCIAL ST STE 401
CONCORD, NH 03301
Merrimack County (603) 789-9150
STEPHANIE R PENNEY APRN, FNP-C
Nurse Practitioner (Family)
60 COMMERCIAL ST STE 401
CONCORD, NH 03301
Merrimack County (603) 789-9150
DANIEL H MORRISON JR. MD
Otolaryngology (Otology & Neurotology)
60 COMMERCIAL ST STE 401
CONCORD, NH 03301
Merrimack County (603) 789-9150

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 Falcone's NPI number?

The NPI number for Carl Falcone is 1801954144. It was assigned to this individual provider in the NPPES registry on December 5, 2006.

Where is Carl Falcone located?

Carl Falcone practices at 60 Commercial St Ste 401, Concord, NH 03301. The listed phone number is (603) 789-9150.

What is Carl Falcone's specialty?

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

Is Carl Falcone enrolled in Medicare?

Yes. Carl Falcone is registered in the Medicare PECOS enrollment system.

What insurance does Carl Falcone accept?

Health plans from Anthem Blue Cross and Blue Shield, AvMed and UnitedHealthcare list Carl Falcone 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.

When was this NPI record last updated?

The NPPES record for Carl Falcone was last updated on January 27, 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.