DOUGLAS CARTER MD
NPI 1528001401
Internal Medicine in Shelbyville, IN
NPI Status: Active since June 14, 2006
Contact Information
150 W WASHINGTON ST
SHELBYVILLE, IN
ZIP 46176
Phone: (317) 392-3211
Fax: (317) 398-1851
- Individual
- Male
- Internal Medicine
- Accepts Insurance
- PECOS Enrolled
About DOUGLAS CARTER
This page provides the complete NPI Profile along with additional information for Douglas Carter, an internist established in Shelbyville, Indiana with a medical specialization in Internal Medicine. The healthcare provider is registered in the NPI registry with number 1528001401 assigned on June 2006. The practitioner's primary taxonomy code is 207R00000X with license number 01027741A (IN). The provider is registered as an individual and his NPI record was last updated 14 years ago.
- NPI
- 1528001401
- Provider Name
- DOUGLAS CARTER MD
- Gender
- Male
- Entity Type
- Individual
- Location Address
- 150 W WASHINGTON ST SHELBYVILLE, IN 46176
- Location Phone
- (317) 392-3211
- Location Fax
- (317) 398-1851
- Mailing Address
- 1626 E STATE ROAD 44 SUITE B SHELBYVILLE, IN 46176
- Mailing Phone
- (317) 421-2012
- Mailing Fax
- (317) 398-1851
- Is Sole Proprietor?
- No
- Enumeration Date
- 06-14-2006
- Last Update Date
- 10-14-2011
- Code Navigator
An internist like Douglas Carter is a physician who has completed an internal medicine residency and is board-certified or board-eligible in an internist specialty. Internists are trained to care for adults of all ages for many different medical conditions. An internist typically monitors chronic physical conditions, identifies acute diseases, provides family planning, provides counseling about wellness and disease prevention, etc.
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Internal Medicine
- Taxonomy Code
- 207R00000X
- Type
- Allopathic & Osteopathic Physicians
- License No.
- 01027741A
- License State
- IN
- Taxonomy Description
- A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Bronze First 7500 $25 Generic Drugs - HMO
- Bronze First 7500 $25 Generic Drugs Adult Vision & Fitness - HMO
- Diabetes Gold 1100 $0 Select Drugs & Specialized Services - HMO
- Diabetes Gold 1100 $0 Select Drugs & Specialized Services Adult Vision & Fitness - HMO
- Diabetes Silver 4000 $0 Select Drugs & Specialized Services - HMO
- Diabetes Silver 4000 $0 Select Drugs & Specialized Services Adult Vision & Fitness - HMO
- Gold 1500 $15 Generic Drugs - HMO
- Gold 1500 $15 Generic Drugs Adult Vision & Fitness - HMO
- HDHP Preventive Silver 5500 $0 Select Drugs - HMO
- Healthy Heart Gold 1500 $0 Select Drugs & Specialized Services - HMO
- Healthy Heart Gold 1500 $0 Select Drugs & Specialized Services Adult Vision & Fitness - HMO
- Healthy Heart Silver 4500 $0 Select Drugs & Specialized Services - HMO
- Healthy Heart Silver 4500 $0 Select Drugs & Specialized Services Adult Vision & Fitness - HMO
- HSA Eligible Bronze 6000 - HMO
- Low Premium Bronze 9200 $25 Generic Drugs - HMO
- Low Premium Bronze 9200 $25 Generic Drugs Adult Vision & Fitness - HMO
- Low Premium Silver 6000 $3 Generic Drugs - HMO
- Low Premium Silver 6000 $3 Generic Drugs Adult Vision & Fitness - HMO
- Platinum Zero $5 Generic Drugs - HMO
- Platinum Zero $5 Generic Drugs Adult Vision & Fitness - HMO
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| E15105 | MEDICARE UPIN (02) | ||
| 100224750A | MEDICAID (05) | IN | |
| 742420D | MEDICARE ID-TYPE UNSPECIFIED (04) |
Medicare Participation & PECOS Enrollment Status
Douglas Carter is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Durable Medical Equipment (DME) and Power Mobility Devices.
What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.
Is the provider registered in PECOS? Yes
Eligible to Order or Refer Part B Clinical Laboratory and Imaging: No
Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes
Eligible to Order or Refer a Home Health Agency (HHA): No
Eligible to Order or Refer Power Mobility Devices: Yes
Areas of Expertise
The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.
Exercise or drug-induced heart stress test with electrocardiogram (ecg) with review by physician
Heart rhythm review and interpretation of continous external ekg over 8-15 days
Heart rhythm review, and interpretation of continous external ekg over more than 48 hours up to 7 days
Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report only
An exercise or drug-induced heart stress test with ECG is a procedure to assess how your heart functions under stress. It can involve exercising or medication to make your heart work harder while an ECG records its activity. A physician reviews the results.
This service was performed 210 times for 197 patientsThis service involves wearing a device for 8-15 days that continuously records your heart's electrical activity. It helps in identifying irregular heart rhythms. The recorded data is then reviewed and interpreted by a healthcare professional for any abnormalities.
This service was performed 34 times for 34 patientsA heart rhythm review involves monitoring your heart's electrical activity for more than 48 hours up to 7 days. Using a device called an external EKG, doctors can track your heartbeats to detect irregularities and help diagnose heart conditions.
This service was performed 94 times for 92 patientsA routine electrocardiogram (ECG) with 12 leads is a simple, non-invasive test that records the electrical activity of your heart. It helps in identifying heart conditions by detecting irregularities in your heart rhythms. The results are interpreted and a report is provided.
This service was performed 1,056 times for 872 patientsPhysician Visit Costs
The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.
For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.
The prices below reflect the costs for new and established patients in the 46176 ZIP code area.
New Patients Visit Costs *
The most utilized procedure code for new patients office visits is 99204
- Average New Patient Price $122.49
- Minimum New Patient Price $53.07
- Maximum New Patient Price $161.76
- Average New Patient Copayment $30.62
- Minimum New Patient Copayment $13.26
- Maximum New Patient Copayment $40.44
Established Patients Visit Costs *
The most utilized procedure code for established patients office visits is 99214
- Average Established Patient Price $94.22
- Minimum Established Patient Price $16.93
- Maximum Established Patient Price $132.22
- Average Established Patient Copayment $23.55
- Minimum Established Patient Copayment $4.23
- Maximum Established Patient Copayment $33.05
* The physician office visit costs information is generated by statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.
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NPI Validation Check Digit Calculation
The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.
| Start with the original NPI number, the last digit is the check digit and is not used in the calculation. | |||||||||
| 1 | 5 | 2 | 8 | 0 | 0 | 1 | 4 | 0 | 1 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 5 | 4 | 8 | 0 | 0 | 2 | 4 | 0 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 5 + 4 + 8 + 0 + 0 + 2 + 4 + 0 + 24 = 49 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 50 - 49 = 1 | 1 | ||||||||
The NPI number 1528001401 is valid because the calculated check digit 1 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the Same Location
The following 18 providers are registered at the same or nearby location.
| NPI | Name / Type | Taxonomy | Address |
|---|---|---|---|
| 1306809934 | ANN E DIDELOT MD Individual | Anesthesiology | 150 W WASHINGTON ST SHELBYVILLE, IN 46176 (317) 567-2179 |
| 1649201005 | DR. FRANK DUGGER BLACK MD Individual | Emergency Medicine | 150 W WASHINGTON ST MAJOR HOSPITAL SHELBYVILLE, IN 46176 (317) 398-5275 |
| 1386665032 | DR. KAHLIL S GLENN M.D. Individual | Anesthesiology (Critical Care Medicine) | 150 W WASHINGTON ST SHELBYVILLE, IN 46176 (317) 392-3211 |
| 1710009014 | OTOLARYNGOLOGY ASSOCIATES LLC Organization | Otolaryngology | 150 W WASHINGTON ST SHELBYVILLE, IN 46176 (317) 844-7059 |
| 1780891804 | INDIANA HEART PHYSICIANS, INC Organization | Internal Medicine (Cardiovascular Disease) | 150 W WASHINGTON ST SHELBYVILLE, IN 46176 (317) 893-1900 |
| 1366635138 | DAVID GILL WHITTAKER MD Individual | Anesthesiology | 150 W WASHINGTON ST SHELBYVILLE, IN 46176 (317) 392-3211 |
| 1669647186 | KELLEY LYNN CARROLL N.P. Individual | Nurse Practitioner (Acute Care) | 150 W WASHINGTON ST SHELBYVILLE, IN 46176 (317) 398-5252 |
| 1336309160 | INDIANA ORTHOPAEDIC CENTER Organization | Orthopaedic Surgery | 150 W WASHINGTON ST SHELBYVILLE, IN 46176 (317) 588-2663 |
| 1720242217 | DR. MICHELLE ANN MELLON M.D. Individual | Anesthesiology | 150 W WASHINGTON ST SHELBYVILLE, IN 46176 (317) 398-5299 |
| 1275836116 | MRS. SHELLEY GAYE SNYDER FNP Individual | Nurse Practitioner (Family) | 150 W WASHINGTON ST SHELBYVILLE, IN 46176 (317) 421-5674 |
| 1558777326 | LAUREN MARIE SEARLES PA-C Individual | Physician Assistant | 150 W WASHINGTON ST SHELBYVILLE, IN 46176 (317) 398-5275 |
| 1386777316 | LAKISHA JONES MS, LAT, ATC Individual | Specialist/Technologist (Athletic Trainer) | 150 W WASHINGTON ST SHELBYVILLE, IN 46176 (765) 860-4250 |
| 1538542121 | ALLISON PASCASCIO PA Individual | Physician Assistant | 150 W WASHINGTON ST SHELBYVILLE, IN 46176 (317) 392-3211 |
| 1790133080 | MAGGIE ABSALOM Individual | Nurse Practitioner (Family) | 150 W WASHINGTON ST SHELBYVILLE, IN 46176 (317) 392-3211 |
| 1154557718 | LAUREN KATHRYN KAISER PA-C Individual | Physician Assistant (Medical) | 150 W WASHINGTON ST SHELBYVILLE, IN 46176 (317) 392-3211 |
| 1306261375 | AMERICAN HEALTH NETWORK OF INDIANA, LLC Organization | Durable Medical Equipment & Medical Supplies | 150 W WASHINGTON ST SHELBYVILLE, IN 46176 (765) 281-3443 |
| 1811371578 | MRS. DANIELLE ELIZABETH FLOWERS PA-C Individual | Physician Assistant | 150 W WASHINGTON ST SHELBYVILLE, IN 46176 (317) 392-3211 |
| 1538192836 | MICHAEL STENNIS MD Individual | Anesthesiology | 150 W WASHINGTON ST SHELBYVILLE, IN 46176 (317) 392-3211 |
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1528001401, enumerated in the NPI registry as an "individual" on June 14, 2006
The provider is located at 150 W Washington St Shelbyville, In 46176 and the phone number is (317) 392-3211
The provider's speciality is Internal Medicine with taxonomy code 207R00000X
The provider might be accepting Accepts: CareSource, Medicare and Medicaid. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.
Yes, as of June 20, 2025 the provider is registered in PECOS and is eligible to order health care services or supplies for Medicare patients. If you are a beneficiary the provider is eligible to order or refer: Durable Medical Equipment (DME) and Power Mobility Devices.
Medicare beneficiaries should expect a typical cost of $122.49 with an average copayment of $30.62 for new patient appointments. Established patients should expect a typical charge of $94.22 and an average copayment of 23.55. Please review your insurance plan or contact the provider directly to determine your specific costs.
The most common procedures or services performed by this practitioner are: Exercise or drug-induced heart stress test with electrocardiogram (ecg) with review by physician, Heart rhythm review and interpretation of continous external ekg over 8-15 days, Heart rhythm review, and interpretation of continous external ekg over more than 48 hours up to 7 days and Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report only.
This NPI record was last updated on June 14, 2006. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
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