Organization Active NPI

Ricardo TDD Carter MD LLC

  • Hematology & Oncology Physician
  • Lewistown, PA
National Provider Identifier
1871609537
Registry record updated Sep 13, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
License
MD041163E Issued in PA
Legal business name
RICARDO TDD CARTER MD LLC
Practice address
310 Electric Ave
Suite 231
Lewistown, PA 17044-1369
Phone
(717) 242-3760
Fax
(717) 242-6230
NPI assigned
Aug 22, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 13, 2022

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

Authorized official

Name
Ricardo TDD Carter, MDNPI 1669457065
Title
Physician
Phone
(717) 242-3760

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hematology & Oncology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RH0003X MD041163E PA Primary

Addresses

Primary practice location

310 Electric Ave
Suite 231
Lewistown, PA 17044-1369

Mailing address

310 Electric Ave
Suite 231
Lewistown, PA 17044-1369
Phone (717) 242-3760

Other identifiers 5

IdentifierTypeStateIssuer
1151OtherPAGEISINGER HEALTH PLAN
172240OtherPAMEDICARE PTAN
1802533OtherPAHIGHMARK BLUE SHIELD
0011276300004MedicaidPA
02631300OtherPACAPITAL BLUE CROSS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100217000257 PA Part B Supplier - Clinic/Group Practice 7517001399 Receives reassigned benefits from 1 practitioner
Practice locations: Lewistown, PA

National Provider Directory

National Provider Directory

Locations

310 Electric Ave
Ste 231
Lewistown, PA 17044
Phone (717) 242-3760

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1156204800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1663027200000",
    "number": "1871609537",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "310 ELECTRIC AVE",
            "address_2": "SUITE 231",
            "city": "LEWISTOWN",
            "state": "PA",
            "postal_code": "170441369",
            "telephone_number": "717-242-3760",
            "fax_number": "717-242-6230"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "310 ELECTRIC AVE",
            "address_2": "SUITE 231",
            "city": "LEWISTOWN",
            "state": "PA",
            "postal_code": "170441369",
            "telephone_number": "717-242-3760",
            "fax_number": "717-242-6230"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RICARDO TDD CARTER MD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-22",
        "last_updated": "2022-09-13",
        "certification_date": "2022-09-13",
        "status": "A",
        "authorized_official_last_name": "CARTER",
        "authorized_official_first_name": "RICARDO",
        "authorized_official_middle_name": "TDD",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "717-242-3760",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "PA",
            "license": "MD041163E",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GEISINGER HEALTH PLAN",
            "identifier": "1151",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "172240",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIGHMARK BLUE SHIELD",
            "identifier": "1802533",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0011276300004",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAPITAL BLUE CROSS",
            "identifier": "02631300",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lewistown, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.