Active NPI 1326001785 Individual Practitioner Male Practitioner

Dr. Carl J Gilbert , MD

Surgery • Edmond, OK

✓ Accepts Medicare Assignment

Professional Overview & Biography Verified Profile Summary

Dr. Carl Gilbert, MD is a certified Surgery practicing in Edmond, OK. With approximately 53 years of clinical experience since completing medical education in 1973, Dr. Gilbert delivers high-quality medical care to the local community at 4509 INTEGRIS PKWY.

Dr. Gilbert is affiliated with Healogics Specialty Physicians Of Oklahoma Pllc and accepts Medicare assignment.

Frequently performed procedures and clinical services include established patient outpatient office visit, visit complexity inherent to evaluation and management associated with medical care services that serve as the continuing focal point for all needed health care services and/or with medical care services that are part of ongoing care related to a patient's, removal of tissue from wound, 20.0 sq cm or less. Full Medicare procedure pricing transparency rates and service volume details are listed on this profile.

Practice Location & Contact Primary Location

Practice Address

4509 Integris Pkwy

Edmond, OK 730348696

Telephone 4056573195

Fax 4056573193

Medicare Profile & Education

Medical School

Other

Graduation Year

1973

Medicare Assignment

✓ Accepts Assignment

Telehealth Flag

In-Person Only

Specialty Benchmarks & Practice Insights

Comparative analytics for Surgery in Edmond, OK

Senior Veteran Specialist (>20 Yrs)

Practitioner Clinical Experience

53 Yrs +22.5 yrs vs City Avg

City Avg: 30.5 Yrs

State Avg: 28.1 Yrs

Regional Practice Density

8 Specialists

Practicing in Edmond, OK (386 Statewide)

Telehealth Adoption Rate

12.5% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount

76.7% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Clinical Seniority & Experience Comparison

Dr. Gilbert (53 Years) 53 Yrs

Edmond Specialty Average (30.5 Years) 30.5 Yrs

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2024)

Reporting Year:

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	433	101	$208.00	$60.64
G2211 Visit complexity inherent to evaluation and management associated with medical care services that serve as the continuing focal point for all needed health care services and/or with medical care services that are part of ongoing care related to a patient's	391	103	$64.00	$15.38
97597 Removal of tissue from wound, 20.0 sq cm or less	244	74	$160.00	$32.29
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	227	71	$321.00	$90.42
11043 Removal of muscle and/or tissue, 20.0 sq cm or less	95	36	$642.00	$141.85
11042 Removal of skin and tissue, 20.0 sq cm or less	92	43	$254.00	$52.86
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	67	67	$525.00	$122.87
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	62	56	$104.00	$32.92
12021 Repair of separation of wound closure with insertion of packing	30	12	$579.00	$114.40
17250 Application of chemical to stop tissue regrowth in wound	28	16	$152.00	$33.07
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	15	15	$310.00	$76.08

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	262	70	$208.00	$62.26
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	204	67	$321.00	$91.97
97597 Removal of tissue from wound, 20.0 sq cm or less	196	58	$151.29	$33.77
11043 Removal of muscle and/or tissue, 20.0 sq cm or less	57	24	$642.00	$142.26
11042 Removal of skin and tissue, 20.0 sq cm or less	50	27	$254.00	$51.35
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	49	49	$525.00	$125.77
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	12	11	$104.00	$33.51

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	79	29	$321.00	$93.17
99213 Established patient office or other outpatient visit, typically 15 minutes	67	28	$208.00	$63.43
97597 Removal of tissue from wound, 20.0 sq cm or less	48	19	$99.00	$34.69
11042 Removal of skin and tissue, 20.0 sq cm or less	23	14	$254.00	$55.26
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	17	17	$525.00	$128.22

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99233 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes	52	23	$140.00	$96.29
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	24	11	$100.00	$66.97
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	21	13	$140.00	$119.51
99223 Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes	18	18	$265.00	$186.52

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99233 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes	207	91	$140.00	$94.21
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	101	45	$100.00	$65.22
11046 Removal of muscle and/or tissue, each additional 20.0 sq cm or less	100	13	$114.00	$50.51
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	84	25	$140.00	$84.66
99223 Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes	62	62	$265.00	$183.04
99215 Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more	43	11	$186.00	$121.02
99222 Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes	30	30	$185.00	$125.41
99213 Established patient office or other outpatient visit, typically 15 minutes	27	22	$95.00	$66.16
11043 Removal of muscle and/or tissue, 20.0 sq cm or less	25	15	$370.00	$129.10
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	11	11	$155.00	$95.18

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99233 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes	313	97	$127.25	$95.09
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	117	46	$95.38	$66.47
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	90	36	$124.17	$97.19
99213 Established patient office or other outpatient visit, typically 15 minutes	90	43	$88.20	$66.16
99223 Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes	86	86	$243.01	$184.76
11046 Removal of muscle and/or tissue, each additional 20.0 sq cm or less	57	12	$102.00	$50.90
99222 Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes	39	39	$168.85	$124.89
12021 Repair of separation of wound closure with insertion of packing	30	12	$232.97	$140.28
11042 Removal of skin and tissue, 20.0 sq cm or less	24	11	$151.25	$104.80
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	19	19	$137.47	$96.13
11043 Removal of muscle and/or tissue, 20.0 sq cm or less	17	15	$315.24	$128.67
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	13	12	$197.31	$147.16

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99233 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes	217	90	$105.48	$95.97
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	152	72	$80.39	$66.97
99213 Established patient office or other outpatient visit, typically 15 minutes	114	43	$77.95	$65.43
99213 Established patient office or other outpatient visit, typically 15 minutes	69	21	$77.78	$47.11
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	68	37	$116.10	$96.92
99223 Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes	66	66	$206.62	$186.47
99222 Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes	60	58	$140.75	$125.57
12021 Repair of separation of wound closure with insertion of packing	37	13	$204.14	$116.02
11043 Removal of muscle and/or tissue, 20.0 sq cm or less	36	13	$237.00	$204.13
11043 Removal of muscle and/or tissue, 20.0 sq cm or less	27	11	$241.93	$134.36
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	23	23	$122.83	$96.33
17250 Application of chemical to stop tissue regrowth in wound	14	12	$88.07	$65.23
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	11	11	$177.00	$148.11

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99233 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes	231	87	$105.68	$94.57
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	196	66	$80.71	$65.64
99213 Established patient office or other outpatient visit, typically 15 minutes	133	46	$77.41	$64.27
11046 Removal of muscle and/or tissue, each additional 20.0 sq cm or less	100	18	$76.00	$50.62
99223 Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes	75	75	$204.00	$183.97
99222 Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes	65	65	$142.08	$123.97
11043 Removal of muscle and/or tissue, 20.0 sq cm or less	51	12	$237.00	$199.77
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	40	29	$115.50	$95.34
12021 Repair of separation of wound closure with insertion of packing	40	11	$184.00	$129.34
11043 Removal of muscle and/or tissue, 20.0 sq cm or less	38	21	$230.76	$126.30
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	15	15	$177.00	$145.89
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	14	14	$115.43	$95.27
99238 Hospital discharge day management, 30 minutes or less	14	14	$80.00	$65.55
11044 Removal of bone, 20.0 sq cm or less	12	12	$350.00	$156.07
44320 Creation of large bowel drainage tract to skin surface	11	11	$1290.00	$1072.64

Medical Specialties & State Licenses

CMS Verified: 2023-04-24

Surgery Primary Specialty

NUCC Taxonomy Code: 208600000X

State License AR E4658

A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery.

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID

159057001 (AR)

Commercial Insurance / Payer ID Blue Cross And Blue Shield

5N462 (AR)

Hospital & Practice Group Affiliations

Healogics Specialty Physicians Of Oklahoma Pllc

4509 Integris Pkwy, Edmond, OK 730348696

Phone: 4056044380

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

8 Historical Events

📍

Updated Practice Location April 24, 2023

Registered at 4509 INTEGRIS PKWY, EDMOND, OK 730348696 (Tel: 4056573195)

📍

Updated Business Mailing Address April 24, 2023

Registered at 4509 INTEGRIS PKWY, EDMOND, OK 730348696

✅

NPI Profile Active September 30, 2013

NPI status registered as active in NPPES database

📍

Updated Practice Location September 30, 2013

Registered at 500 S UNIVERSITY AVE, SUITE 702, LITTLE ROCK, AR 722055302 (Tel: 5015583000)

📍

Updated Business Mailing Address September 30, 2013

Registered at 500 S UNIVERSITY AVE, SUITE 702, LITTLE ROCK, AR 722055302 (Tel: 5015583000)

👤

Provider Name / Credentials Updated September 30, 2013

Recorded as CARL GILBERT, MD

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) September 30, 2013

Surgery (License #E4658 in AR)

🟢

Initial NPI Registration & Enumeration April 07, 2006

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

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NPI Administrative Meta

NPI Number: 1326001785

Entity Type:

Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)

Enumeration Date: April 07, 2006

Last Update: April 24, 2023

Sole Proprietor: Yes

Update or Correct Profile

Mailing Address

4509 Integris Pkwy

Edmond, OK 730348696

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).

⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.