MATTHEW CARMICHAEL M.D.
NPI 1871820852
Otolaryngology in Lawrenceville, GA

Active since November 11, 2009PECOS EnrolledAccepts Medicare Assignment
92.26/100
CMS Quality Rating
766 WALTHER RD STE 300, LAWRENCEVILLE, GA 30046(770) 237-3000 Get Directions Write a Review

NPPES record last updated: July 3, 2018. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Matthew Carmichael M.d. NPPES

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

MATTHEW CARMICHAEL M.D. (NPI 1871820852) is an individual otolaryngology provider in Lawrenceville, Georgia, licensed in Georgia (79617) and active in the NPI registry since November 2009. He is enrolled in Medicare PECOS, is affiliated with Northside Hospital Gwinnett, and maintains a secondary practice location in Suwanee.

NPPES Registry Identity

NPI1871820852
Entity TypeIndividualMale
Primary Taxonomy207Y00000X
Provider Legal NameMATTHEW CARMICHAELCredential: M.D.
Location Address766 WALTHER RD STE 300Lawrenceville, GA 30046
Mailing Address766 Walther Rd Ste 300Lawrenceville, GA 30046-8765 · (770) 237-3000
Sole ProprietorNo
Medical School CMSOtherGraduated 2013
Enumeration DateNovember 11, 2009
Last NPPES UpdateJuly 3, 2018
NPI 1871820852 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyOtolaryngologyAllopathic & Osteopathic Physicians
Taxonomy Code207Y00000X
License Licensed in GA · 79617
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.
766 WALTHER RD STE 300, Lawrenceville, GA 30046

Secondary Practice Location 1

Location 14385 Johns Creek Pkwy Ste 250Suwanee, GA 30024-6095 · Phone (770) 623-1608

Accepted 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

Matthew Carmichael M.d. 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 ID9234487398
PECOS Enrollment IDI20180806002017
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 10

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 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.
454 services332 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.
240 services173 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.
124 services124 patients
Diagnostic exam of nasal passages using an endoscope 31231
A diagnostic exam of nasal passages using an endoscope is a non-invasive procedure. A small, flexible tube with a light and camera at the end, called an endoscope, is inserted into the nose. This allows the doctor to view the nasal passages and sinuses, helping to identify any issues.
122 services83 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.
99 services99 patients
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.
61 services57 patients

Hospital Affiliations CMS Care Compare 4

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

Northside Hospital Gwinnett

Acute Care Hospitals · Lawrenceville, GA
2/5 CMS rating
OwnershipGovernment - Hospital District or Authority
CMS Certification Number110087
Location1000 Medical Center BoulevardLawrenceville, GA 30046 · Gwinnett County
Birthing friendly

Northside Hospital

Acute Care Hospitals · Atlanta, GA
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number110161
Location1000 Johnson Ferry Road, NEAtlanta, GA 30342 · Fulton County
Birthing friendly

Emory Johns Creek Hospital

Acute Care Hospitals · Johns Creek, GA
3/5 CMS rating
OwnershipProprietary
CMS Certification Number110230
Location6325 Hospital ParkwayJohns Creek, GA 30097 · Gwinnett County
Emergency services Birthing friendly

Northside Hospital Duluth

Acute Care Hospitals · Duluth, GA
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number110252
Location3620 Howell Ferry RoadDuluth, GA 30096 · Gwinnett County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 30046 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
$130.64 typical visit price
range $56.84 – $172.43
Typical copayment $32.66 (range $14.21 – $43.10)
Most-billed visit code 99204
Established Patient
$70.85 typical visit price
range $18.22 – $140.40
Typical copayment $17.71 (range $4.55 – $35.10)
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.

92.26/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored through an Alternative Payment Model
Quality73.83
Promoting Interoperability100
Improvement Activities40

Referred Medical Equipment & Supplies CMS DME claims 10

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Tubing with integrated heating element for use with positive airway pressure device A4604
DME-Other DME · category DE001N
11 suppliers25 claims25 services$32.17 avg. paid by Medicare
Cushion for use on nasal mask interface, replacement only, each A7032
DME-Other DME · category DE001N
10 suppliers28 claims152 services$14.74 avg. paid by Medicare
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap A7034
DME-Other DME · category DE001N
12 suppliers36 claims36 services$47.87 avg. paid by Medicare
Headgear used with positive airway pressure device A7035
DME-Other DME · category DE001N
10 suppliers25 claims25 services$14.66 avg. paid by Medicare
Tubing used with positive airway pressure device A7037
DME-Other DME · category DE001N
5 suppliers14 claims14 services$9.61 avg. paid by Medicare
Filter, disposable, used with positive airway pressure device A7038
DME-Other DME · category DE001N
12 suppliers38 claims217 services$1.65 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

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.

Nurse Practitioner (Family)
766 WALTHER RD STE 300
LAWRENCEVILLE, GA 30046
Otolaryngology
766 WALTHER RD STE 300
LAWRENCEVILLE, GA 30046
Otolaryngology
766 WALTHER RD STE 300
LAWRENCEVILLE, GA 30046
Audiologist
766 WALTHER RD STE 300
LAWRENCEVILLE, GA 30046
Otolaryngology
766 WALTHER RD STE 300
LAWRENCEVILLE, GA 30046

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 Matthew Carmichael's NPI number?

The NPI number for Matthew Carmichael is 1871820852. It was assigned to this individual provider in the NPPES registry on November 11, 2009.

Where is Matthew Carmichael located?

Matthew Carmichael practices at 766 Walther Rd Ste 300, Lawrenceville, GA 30046. The listed phone number is (770) 237-3000.

What is Matthew Carmichael's specialty?

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

Is Matthew Carmichael enrolled in Medicare?

Yes. Matthew Carmichael 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 Matthew Carmichael accept?

Health plans from Ambetter Health, Ambetter from Absolute Total Care, Ambetter of Alabama, Ambetter of North Carolina and Ambetter of Tennessee list Matthew Carmichael 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 Matthew Carmichael affiliated with any hospitals?

According to CMS data, Matthew Carmichael is affiliated with Northside Hospital Gwinnett, Northside Hospital, Emory Johns Creek Hospital and Northside Hospital Duluth.

When was this NPI record last updated?

The NPPES record for Matthew Carmichael was last updated on July 3, 2018. NPI Profile syncs with the weekly NPPES data releases published by CMS.