NPIMap

Individual provider Active NPI

Charles Benjamin Carter Jr., M.D.

  • Nephrology Physician
  • Tucson, AZ
National Provider Identifier
1235136565
Registry record updated May 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
62734 Issued in AZ
Practice address
4511 N Campbell Ave Ste 100
Tucson, AZ 85718-6424
Phone
(520) 529-6500
Fax
(520) 209-7337
NPI assigned
Jul 1, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 20, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X 62734 AZ Primary

Addresses

Primary practice location

4511 N Campbell Ave Ste 100
Tucson, AZ 85718-6424

Mailing address

6622 N 91St Ave Ste 220
Glendale, AZ 85305-2569
Phone (602) 759-6883

Other identifiers 2

IdentifierTypeStateIssuer
200199750AMedicaidIN
090305MedicaidAZ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN, AZ2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20100729000024 IN Practitioner - NephrologyPractitioner - Internal Medicine 0648303545
I20210413001376 AZ Practitioner - Nephrology 0648303545 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nephrology
Education
University of New Mexico School of Medicine, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Akdhc LLCGroup PAC ID 8123912136, 125 clinicians

Practice addresses (Care Compare)

4511 N Campbell Ave
Suite 100
Tucson, AZ 85718-6424
Phone (520) 529-6500

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
88.2 of 100Reported as group
Quality
67.68
Promoting interoperability
100
Improvement activities
40
Cost
76.33

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
62734AZMDNephrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Akdhc, LLC Nephrology Current Accepting new patients
Akdhc, LLC Nephrology CurrentSince Apr 5, 2021 Accepting new patients
Akdhc Surgery Center, LLC Nephrology Current Accepting new patients
Akdhc, LLC Nephrology CurrentSince Apr 5, 2021 Accepting new patients
Major Hospital Past Accepting new patients

Locations

451 S Calvary Way
Cottonwood, AZ 86326
Phone (928) 649-7997

6622 N 91st Ave
Ste 220
Glendale, AZ 85305
Phone (602) 759-6883

6622 N 91st Ave
Ste 200
Glendale, AZ 85305
Phone (623) 547-4668

6622 N 91st Ave
Ste 100
Glendale, AZ 85305
Phone (623) 547-4668

13657 W McDowell Rd
Ste 210
Goodyear, AZ 85395
Phone (623) 243-6538

3320 N 2nd St
Phoenix, AZ 85012
Phone (602) 200-8288

1500 S White Mountain Rd
Ste 201
Show Low, AZ 85901
Phone (928) 251-0386

5555 Mesa Verde Dr
Ste 100
Sierra Vista, AZ 85635
Phone (520) 529-6500

4511 N Campbell Ave
Ste 100
Tucson, AZ 85718
Phone (520) 529-4013

Interoperability endpoints

  • Direct secure messaging: charles.carter.1@11625.direct.athenahealth.com

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1120176000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621468800000",
    "number": "1235136565",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6622 N 91ST AVE STE 220",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853052569",
            "telephone_number": "602-759-6883",
            "fax_number": "602-224-3315"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4511 N CAMPBELL AVE STE 100",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857186424",
            "telephone_number": "520-529-6500",
            "fax_number": "520-209-7337"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARTER",
        "first_name": "CHARLES",
        "middle_name": "BENJAMIN",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-01",
        "last_updated": "2021-05-20",
        "certification_date": "2021-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "AZ",
            "license": "62734",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200199750A",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "090305",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tucson, AZ

Sources for this page

Verify at the official NPI Registry.