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KRISTEN DECARLO FNP-C
NPI 1881004323
Nurse Practitioner in Dallas, WV

Active since May 06, 2014PECOS EnrolledAccepts Medicare Assignment
94.1/100
CMS Quality Rating
4935 STONE CHURCH RD, DALLAS, WV 26036(304) 547-5566 Get Directions Write a Review

NPPES record last updated: July 14, 2014. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Kristen Decarlo Fnp-c NPPES

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

KRISTEN DECARLO FNP-C (NPI 1881004323) is an individual nurse practitioner in Dallas, West Virginia, licensed in West Virginia (APRN74352NP) and active in the NPI registry since May 2014. She is enrolled in Medicare PECOS, is affiliated with Barnesville Hospital Association, Inc, and is a graduate of Other (2014).

NPPES Registry Identity

NPI1881004323
Entity TypeIndividualFemale
Primary Taxonomy363L00000X
Provider Legal NameKRISTEN DECARLOCredential: FNP-C
Location Address4935 STONE CHURCH RDDallas, WV 26036-1131
Mailing Address4935 Stone Church RdDallas, WV 26036-1131 · (304) 547-5566
Phone(304) 547-5566
Sole ProprietorYes
Medical School CMSOtherGraduated 2014
Enumeration DateMay 6, 2014
Last NPPES UpdateJuly 14, 2014
✔ NPI 1881004323 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363L00000X
License✔ Licensed in WV · APRN74352NP
Definition
(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.
4935 STONE CHURCH RD, Dallas, WV 26036
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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

Kristen Decarlo Fnp-c 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 ID5092031153
PECOS Enrollment IDI20150307000169
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 4

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.
76 services59 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.
71 services64 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.
36 services36 patients
Telephone medical discussion with physician, 5-10 minutes 99441
A telephone medical discussion with a physician is a brief, 5-10 minute call where you can discuss your health concerns. It's a convenient way to receive medical advice without needing to visit a clinic. It's important to prepare questions in advance to make the most of this time.
24 services20 patients

Hospital Affiliations CMS Care Compare 5

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

Barnesville Hospital Association, Inc

Critical Access Hospitals · Barnesville, OH
OwnershipVoluntary non-profit - Private
CMS Certification Number361321
Location639 West Main StreetBarnesville, OH 43713 · Belmont County
Emergency services

Reynolds Memorial Hospital

Acute Care Hospitals · Glen Dale, WV
2/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number510013
Location800 Wheeling AveGlen Dale, WV 26038 · Marshall County
Emergency services Birthing friendly

Weirton Medical Center, Inc

Acute Care Hospitals · Weirton, WV
2/5 CMS rating
OwnershipGovernment - Local
CMS Certification Number510023
Location601 Colliers WayWeirton, WV 26062 · Hancock County
Emergency services

Wheeling Hospital, Inc

Acute Care Hospitals · Wheeling, WV
1/5 CMS rating
OwnershipVoluntary non-profit - Church
CMS Certification Number510050
Location1 Medical ParkWheeling, WV 26003 · Ohio County
Emergency services Birthing friendly

Wetzel County Hospital

Acute Care Hospitals · New Martinsville, WV
OwnershipGovernment - Local
CMS Certification Number510072
Location#3 East Benjamin DriveNew Martinsville, WV 26155 · Wetzel County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 26036 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
$83.49 typical visit price
range $53.20 – $164.59
Typical copayment $20.87 (range $13.30 – $41.14)
Most-billed visit code 99203
Established Patient
$94.81 typical visit price
range $16.47 – $133.29
Typical copayment $23.70 (range $4.11 – $33.32)
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.

94.1/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored through an Alternative Payment Model
Quality78.46
Promoting Interoperability100
Improvement Activities40

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 Kristen Decarlo's NPI number?

The NPI number for Kristen Decarlo is 1881004323. It was assigned to this individual provider in the NPPES registry on May 6, 2014.

Where is Kristen Decarlo located?

Kristen Decarlo practices at 4935 Stone Church Rd, Dallas, WV 26036. The listed phone number is (304) 547-5566.

What is Kristen Decarlo's specialty?

The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.

Is Kristen Decarlo enrolled in Medicare?

Yes. Kristen Decarlo 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 Kristen Decarlo accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Meridian, CareSource and Highmark Blue Cross Blue Shield West Virginia and 1 other insurer list Kristen Decarlo 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 Kristen Decarlo affiliated with any hospitals?

According to CMS data, Kristen Decarlo is affiliated with Barnesville Hospital Association, Inc, Reynolds Memorial Hospital, Weirton Medical Center, Inc, Wheeling Hospital, Inc and Wetzel County Hospital.

When was this NPI record last updated?

The NPPES record for Kristen Decarlo was last updated on July 14, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 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.