2026 NPPES data Hospitalist Physician NPI 1255780383 M.D.
Verify on CMS →

VALERIE CARTER, M.D.

Hospitalist Physician in MILWAUKEE, Wisconsin. CMS National Plan and Provider Enumeration System profile including specialty classification, practice address, and Medicare prescribing data when reported.

Federal data — no proprietary rating. PlainDoctor publishes the actual CMS NPPES and Medicare records — NPI registration, specialty, practice location, and prescribing data — without a composite score or editorial opinion on top. Every field traces to a federal source.
Prescribing volume
169
Medicare Part D claims · 81 beneficiaries · Hospitalist Physician avg: 888
MIPS score
80.4671/100
▼ 3 pts below national avg 83.1 · [object Object]

What the federal data shows

VALERIE CARTER, M.D. reported a CMS MIPS final score of 80.4671/100 — below the 83.1 national average — and filed 169 Medicare Part D claims in 2023.

80.4671/100
MIPS score · -3 vs avg
169
Part D claims, 2023
Likely
board-certified (heuristic)

Every figure on this page comes straight from federal CMS records (NPPES, Medicare Part D, MIPS, Open Payments) — no proprietary rating or editorial opinion is applied.

VALERIE CARTER, M.D.'s MIPS score vs every scored U.S. clinician

CMS Merit-based Incentive Payment System (MIPS) final score, 2023 — the federal quality measure

80 33rd percentile higher than 33% of 477,587 scored providers

0–10: 8,684 scored providers (2%). Below this entry. 10–20: 3,008 scored providers (1%). Below this entry. 20–30: 3,069 scored providers (1%). Below this entry. 30–40: 2,746 scored providers (1%). Below this entry. 40–50: 2,928 scored providers (1%). Below this entry. 50–60: 5,882 scored providers (1%). Below this entry. 60–70: 13,906 scored providers (3%). Below this entry. 70–80: 118,074 scored providers (25%). Below this entry. 80–90: 129,887 scored providers (27%). This entry sits in this band. 90–100: 189,403 scored providers (40%). Above this entry. This provider 0 100 every MIPS-scored clinician, bucketed by value

Each bar is a band; taller bars hold more scored providers. The dashed line + filled bar mark this entry. Hover or tap any bar for its full count, share, and where it sits relative to this entry.

Source CMS Merit-based Incentive Payment System (MIPS) · 2023

Board certification likely (heuristic — not verified)

VALERIE CARTER, M.D. practices in an ABMS-board-eligible specialty and shows active CMS Medicare participation + MIPS quality reporting + 2 hospital affiliations — signals consistent with board-certified status. For verified board certification, see CertificationMatters.org (the official ABMS public lookup).

What does the federal data show about VALERIE CARTER, M.D.?

Near national average

NPI registry status

Active

Issued 06/09/2016

NPI 1255780383

Primary specialty

Hospitalist Physician

Mid-sized

16,825 US NPIs in this specialty

Medicare Part D claims

169 81% vs specialty avg

2023 prescription claims

Specialty avg: 888

MIPS final score

80.4671/100 2.6328999999999922% pts

Above neutral band

vs 83.1 national avg

Specialty distribution in Wisconsin

How Hospitalist Physician compares to other specialties among Wisconsin providers

Wisconsin providers

Hospitalist Physician share within Wisconsin

1. Hospitalist Physician42%2. Internal medicine21%3. Family medicine17%4. Surgical12%5. Pediatric8%
Hospitalist Physician share within Wisconsin

Medicare quality performance — MIPS

VALERIE CARTER, M.D.'s 2023 MIPS final score plotted against the Hospitalist Physician national average

Near national average
MIPS Final Score
80.4671/100
vs 83.1 national avg · 2023 performance year

MIPS final score (Hospitalist Physician) — 80.4671/100 vs national avg 83.1

0%100%National avg83%80.5%
MIPS final score (Hospitalist Physician) — 80.4671/100 vs national avg 83.1

The Merit-based Incentive Payment System (MIPS) scores providers 0–100 across four performance categories: Quality, Cost, Promoting Interoperability, and Improvement Activities, weighted under 42 CFR §414.1380. Reporting is voluntary for many small practices, so absence of a MIPS score is not a quality signal.

Board certification through an ABMS or AOA member board signals voluntary post-licensure examination plus continuous Maintenance of Certification cycles. Verify any individual provider's status through certificationmatters.org (ABMS) or osteopathic.org (AOA).

VALERIE CARTER, M.D. appears in the CMS NPPES registry as a Hospitalist Physician provider holding M.D. credentials at 9200 W WISCONSIN AVE, MILWAUKEE, WI, 53226, with a listed phone of (414) 805-0812. NPI 1255780383 was issued on 06/09/2016. Because NPPES data is self-reported by the provider and refreshed monthly, the address, phone, and specialty reflect what CARTER most recently submitted to CMS rather than a vetted directory listing, which is why patients should always confirm the practice is still at this location before scheduling.

Medicare Part D records for calendar year 2023 show 169 prescription claims written by this provider, covering 81 Medicare beneficiaries and totaling roughly $11K in drug spend. These figures capture only Medicare Part D — commercial insurance, Medicaid, and cash-pay prescriptions are not included, and any drug-beneficiary cell under 11 is suppressed by CMS for patient privacy. On the CMS Merit-based Incentive Payment System, this provider earned a Final Score of 80.4671/100 for the 2023 performance year (Quality 66.2426, Cost 68.6477), compared with the national average of 83.1.

Hospitalist Physician is a mid-sized specialty nationwide, with 16,825 enrolled providers across 54 states and an average of 888 Part D claims per prescriber, so the context for interpreting these metrics differs meaningfully from a primary-care baseline. Important: PlainDoctor is a directory of publicly available government data, not medical advice, a malpractice database, or a quality rating. Inclusion here does not imply a recommendation, and absence of complaints or sanctions on this page does not mean none exist — always verify credentials through the NPPES NPI Registry, your state medical board, and the ABMS or AOA before making healthcare decisions.

Practice Address

9200 W WISCONSIN AVE
MILWAUKEE, WI 53226

Provider Details

NPI 1255780383
Specialty Hospitalist Physician
Credentials M.D.
Gender Female
NPI Issued 06/09/2016

CMS Quality Score (MIPS)

Merit-based Incentive Payment System (MIPS) scores from CMS, 2023 performance year.

80.4671
Final Score
Avg: 83.1
66.2426
Quality
68.6477
Cost
100
Promoting Interoperability

Reporting: Group practice

Hospital and facility affiliations

Facilities where VALERIE CARTER, M.D. bills Medicare from. Star ratings (1-5) are CMS Hospital Compare's "Hospital overall rating" — a composite of mortality, readmission, patient experience, safety, timely care, and efficient use of medical imaging measures. Source: CMS Care Compare.

NORTHEAST MEDICAL GROUP INC
GREENWICH, CT
THE MEDICAL COLLEGE OF WISCONSIN INC
MILWAUKEE, WI

Affiliations sourced from CMS Doctors and Clinicians National Downloadable File; hospital ratings from CMS Hospital General Information dataset (cross-referenced by facility name + state).

Medicare Part D Prescribing Data

CMS Medicare Part D prescriber-level data for calendar year 2023.

169
Total Claims
$11K
Total Drug Cost
81
Medicare Beneficiaries

Prescribing Breakdown

30-Day Fills
198
Total Day Supply
4,092
Generic Drug Cost
$2K
Antibiotic Claims
40

Patient Demographics

Average Patient Age
79.7 years
Avg HCC Risk Score
2.11
Gender Split
59% female / 41% male

Hospitalist Physician Overview

How VALERIE CARTER, M.D. fits within the Hospitalist Physician landscape nationally.

16,825
Hospitalist Physician Providers in US
54
States with Hospitalist Physician
888
Avg Claims per Provider

VALERIE CARTER, M.D.'s 169 claims are below the specialty average of 888.

Nearby Hospitalist Physician Providers in Wisconsin

Other clinicians with the same primary specialty enrolled in Wisconsin, drawn from the same CMS NPPES roster as CARTER.

Compare Hospitalist Physician nationally: see state-by-state distribution →

Frequently Asked Questions

What is VALERIE CARTER, M.D.'s specialty?
VALERIE CARTER, M.D. specializes in Hospitalist Physician and practices in MILWAUKEE, Wisconsin. Credentials: M.D..
How much does VALERIE CARTER, M.D. prescribe under Medicare Part D?
In 2023, VALERIE CARTER, M.D. wrote 169 Medicare Part D claims totaling $11K in drug costs for 81 beneficiaries.
What is VALERIE CARTER, M.D.'s Medicare quality score?
VALERIE CARTER, M.D. has a CMS MIPS Final Score of 80.4671/100 (Quality: 66.2426, Cost: 68.6477). The national average MIPS Final Score is 83.1. Source: CMS Merit-based Incentive Payment System (MIPS) 2023.
Where is VALERIE CARTER, M.D. located?
VALERIE CARTER, M.D. is located at 9200 W WISCONSIN AVE, MILWAUKEE, WI, 53226. Phone: (414) 805-0812.
What is VALERIE CARTER, M.D.'s NPI number?
VALERIE CARTER, M.D.'s National Provider Identifier (NPI) is 1255780383, issued on 06/09/2016.
How many Hospitalist Physician providers are there in the US?
There are 16,825 Hospitalist Physician providers across 54 states in the US. The average Hospitalist Physician provider writes 888 Medicare Part D claims per year.
Does VALERIE CARTER, M.D. accept Medicare?
VALERIE CARTER, M.D. appears in CMS Medicare data with 169 Part D claims and 81 Medicare beneficiaries in 2023. Contact the provider's office directly to confirm current Medicare enrollment and accepted plans.
How can I verify VALERIE CARTER, M.D.'s credentials?
VALERIE CARTER, M.D.'s NPI is 1255780383 with credentials M.D.. You can verify this through the NPPES NPI Registry, check state medical board records, and confirm board certification through the ABMS or AOA.

Data Sources

Provider Directory
CMS National Plan and Provider Enumeration System (NPPES), download.cms.gov/nppes, updated monthly. Contains NPI, specialty, credentials, and practice location.
Specialty Classification
NUCC Health Care Provider Taxonomy (nucc.org), the industry standard for classifying provider specialties in Medicare and Medicaid billing.
Prescribing Data
CMS Medicare Part D Prescriber Public Use File (2023). Includes claims, drug costs, beneficiaries, and opioid prescribing rates.
Quality Performance
CMS Merit-based Incentive Payment System (MIPS) — 2023 performance year.
Limitations
Provider data is self-reported to CMS. Prescribing data reflects Medicare Part D only and does not include commercial insurance, Medicaid, or cash prescriptions. Claims below 11 beneficiaries are suppressed by CMS for privacy.

See our complete data methodology for details on how we collect and process government data.

Data as of April 2026 (NPPES) / 2023 (Medicare Part D). Source: Centers for Medicare & Medicaid Services (CMS).

Disclaimer: Data from CMS NPPES and Medicare Part D. PlainDoctor does not rate or rank providers. Provider information is self-reported and may not be current. Always verify information directly with the provider. About · Methodology