Carla Marie Carvalho, MD
General Surgery · San Jose
- Medicare standing
- Clear
- Enrolled, allowed to bill and order, not excluded
- Plans that list them
- 19
- 4 carriers
- Office
- 1
Offices
1 location · County of Santa Clara · 1,000 clinicians in this group
Looking this up.
Hospitals listed: Santa Clara Valley Medical Center. That is not proof they admit you there this week.
Plans that list them
19 plans · 4 carriers
A missing listing does not mean out of network. Directories change, and a listing does not cover every office. Call Dr. Carvalho’s office to confirm they take your plan. Ask about the office you use, its medical group, referrals and appointments.
19 of 19 plans
| Alignment Health BreathEasy (HMO C-SNP) | Alignment Health Plan | Listed | Oct 3, 2026 |
| Alignment Health Clarity (HMO C-SNP) | Alignment Health Plan | Listed | Oct 3, 2026 |
| Alignment Health Harmony (HMO) | Alignment Health Plan | Listed | Oct 3, 2026 |
| Alignment Health Heart & Diabetes (HMO C-SNP) | Alignment Health Plan | Listed | Oct 3, 2026 |
| Alignment Health Heart & Diabetes CalPlus (HMO C-SNP) | Alignment Health Plan | Listed | Oct 3, 2026 |
| Alignment Health Heart & Diabetes Care (HMO C-SNP) | Alignment Health Plan | Listed | Sep 28, 2026 |
| Alignment Health Heart & Diabetes Choice (HMO C-SNP) | Alignment Health Plan | Listed | Sep 28, 2026 |
| Alignment Health Honor+ Plan (HMO) | Alignment Health Plan | Listed | Oct 3, 2026 |
| Alignment Health My Choice CalCare (HMO) | Alignment Health Plan | Listed | Oct 3, 2026 |
| Alignment Health Silicon (HMO C-SNP) | Alignment Health Plan | Listed | Oct 3, 2026 |
| Alignment Health smartHMO (HMO) | Alignment Health Plan | Listed | Oct 3, 2026 |
| Alignment Health the ONE (HMO) | Alignment Health Plan | Listed | Oct 3, 2026 |
| Anthem Full Dual Advantage Aligned (HMO D-SNP) | Anthem Blue Cross | Listed | Oct 3, 2026 |
| Anthem Medicare Advantage (HMO-POS) | Anthem Blue Cross | Listed | Oct 3, 2026 |
| SCAN Balance (HMO C-SNP) | SCAN Health Plan | Listed | Oct 3, 2026 |
| SCAN Classic (HMO) | SCAN Health Plan | Listed | Oct 3, 2026 |
| SCAN MyChoice (HMO) | SCAN Health Plan | Listed | Oct 3, 2026 |
| SCAN Strive (HMO C-SNP) | SCAN Health Plan | Listed | Oct 3, 2026 |
| DualConnect (HMO D-SNP) | Santa Clara Family Health Plan | Listed | Sep 1, 2026 |
California Medical Board record
Licence A116687 · Current
Licensed to practise in California · since 2011 · expires 2028-08-31 · Rush Medical College of Rush University.
No disciplinary actions, convictions, malpractice judgments or citations in this record.
Hospitals they work in
1 hospital
These rate the hospital, not this clinician. Most measures at most hospitals are no different from the national rate.
- Santa Clara Valley Medical CenterSan Jose, CAAcute Care Hospital · Government - Local · Has an emergency department · Birthing-friendlyPart of Santa Clara Valley Health and Hospital System, which runs 3 hospitalsPatients rate it 3 of 5 · 70% would definitely recommend itOverall rating: 2 of 5 starsWorse than the national rate — SSI - Colon Surgery: 2.572, Oct 2024 – Sep 2025Better than the national rate — Central Line Associated Bloodstream Infection (ICU + select Wards): 0.563, Oct 2024 – Sep 2025Better than the national rate — Clostridium Difficile (C.Diff): 0.256, Oct 2024 – Sep 2025Better than the national rate — MRSA Bacteremia: 0.369, Oct 2024 – Sep 2025
See every measure and the patient survey for Santa Clara Valley Medical Center
Behind the star rating — Deaths: 2 better, 6 the same, 0 worse of 8 measures. Safety: 2 better, 5 the same, 1 worse of 8 measures. Readmissions: 0 better, 10 the same, 1 worse of 11 measures. The star rating is worked out from an earlier period than the measures below, so the two can disagree.
| SSI - Colon SurgeryInfections | 2.572 | Worse | Oct 2024 – Sep 2025 |
| Central Line Associated Bloodstream Infection (ICU + select Wards)Infections | 0.563 | Better | Oct 2024 – Sep 2025 |
| Clostridium Difficile (C.Diff)Infections | 0.256 | Better | Oct 2024 – Sep 2025 |
| MRSA BacteremiaInfections | 0.369 | Better | Oct 2024 – Sep 2025 |
| Abdominopelvic accidental puncture or laceration rateComplications and deaths | 1.25 (0.3 to 2.2) · 1,535 cases | No different | Jul 2022 – Jun 2024 |
| CMS Medicare PSI 90: Patient safety and adverse events compositeComplications and deaths | 1.07 (0.76 to 1.38) | No different | Jul 2022 – Jun 2024 |
| Death rate among surgical inpatients with serious treatable complicationsComplications and deaths | 214.59 (167.38 to 261.8) · 108 cases | No different | Jul 2022 – Jun 2024 |
| Death rate for CABG surgery patientsComplications and deaths | 2.8 · 41 cases | None | Jul 2022 – Jun 2025 |
| Death rate for COPD patientsComplications and deaths | 6 · 141 cases | None | Jul 2022 – Jun 2025 |
| Death rate for heart attack patientsComplications and deaths | 10.2 · 124 cases | None | Jul 2022 – Jun 2025 |
| Death rate for heart failure patientsComplications and deaths | 8.3 · 501 cases | None | Jul 2022 – Jun 2025 |
| Death rate for pneumonia patientsComplications and deaths | 14.9 · 653 cases | None | Jul 2022 – Jun 2025 |
| Death rate for stroke patientsComplications and deaths | 10.1 · 348 cases | None | Jul 2023 – Jun 2025 |
| Hybrid Hospital-Wide All-Cause Risk Standardized Mortality RateComplications and deaths | 3 · 4,502 cases | None | Jul 2024 – Jun 2025 |
| Iatrogenic pneumothorax rateComplications and deaths | 0.24 (0.04 to 0.43) · 9,014 cases | No different | Jul 2022 – Jun 2024 |
| In-hospital fall-associated fracture rateComplications and deaths | 0.34 (0.15 to 0.52) · 9,216 cases | No different | Jul 2022 – Jun 2024 |
| Perioperative pulmonary embolism or deep vein thrombosis rateComplications and deaths | 4.54 (2.51 to 6.58) · 1,421 cases | No different | Jul 2022 – Jun 2024 |
| Postoperative acute kidney injury requiring dialysis rateComplications and deaths | 1.54 (0 to 3.2) · 288 cases | No different | Jul 2022 – Jun 2024 |
| Postoperative hemorrhage or hematoma rateComplications and deaths | 2.11 (0.66 to 3.56) · 1,446 cases | No different | Jul 2022 – Jun 2024 |
| Postoperative respiratory failure rateComplications and deaths | 11.61 (4.09 to 19.14) · 294 cases | No different | Jul 2022 – Jun 2024 |
| Postoperative sepsis rateComplications and deaths | 7.29 (3.39 to 11.2) · 299 cases | No different | Jul 2022 – Jun 2024 |
| Postoperative wound dehiscence rateComplications and deaths | 1.9 (0.45 to 3.36) · 333 cases | No different | Jul 2022 – Jun 2024 |
| Pressure ulcer rateComplications and deaths | 0.23 (0 to 0.78) · 7,538 cases | No different | Jul 2022 – Jun 2024 |
| Rate of complications for hip/knee replacement patientsComplications and deaths | 5.4 · 94 cases | None | Apr 2023 – Mar 2025 |
| Catheter Associated Urinary Tract Infections (ICU + select Wards)Infections | 0.735 | No different | Oct 2024 – Sep 2025 |
| SSI - Abdominal HysterectomyInfections | 2.573 | No different | Oct 2024 – Sep 2025 |
| Acute Myocardial Infarction (AMI) 30-Day Readmission RateUnplanned return visits | 14.6 · 185 cases | None | Jul 2023 – Jun 2025 |
| Heart failure (HF) 30-Day Readmission RateUnplanned return visits | 22.1 · 951 cases | None | Jul 2023 – Jun 2025 |
| Hospital return days for heart attack patientsUnplanned return visits | 56.3 · 128 cases | None | Jul 2022 – Jun 2025 |
| Hospital return days for heart failure patientsUnplanned return visits | 6.4 · 644 cases | None | Jul 2022 – Jun 2025 |
| Hospital return days for pneumonia patientsUnplanned return visits | 1.3 · 699 cases | None | Jul 2022 – Jun 2025 |
| Pneumonia (PN) 30-Day Readmission RateUnplanned return visits | 16.3 · 921 cases | None | Jul 2023 – Jun 2025 |
| Rate of emergency department (ED) visits for patients receiving outpatient chemotherapyUnplanned return visits | 5.7 (3.9 to 8.1) · 226 cases | No different | Jan 2024 – Dec 2024 |
| Rate of inpatient admissions for patients receiving outpatient chemotherapyUnplanned return visits | 12.6 (9.4 to 16.5) · 226 cases | No different | Jan 2024 – Dec 2024 |
| Rate of readmission after hip/knee replacementUnplanned return visits | 5.4 · 94 cases | None | Jul 2023 – Jun 2025 |
| Rate of readmission for CABGUnplanned return visits | 11.4 · 54 cases | None | Jul 2023 – Jun 2025 |
| Rate of readmission for chronic obstructive pulmonary disease (COPD) patientsUnplanned return visits | 20.3 · 242 cases | None | Jul 2023 – Jun 2025 |
| Rate of unplanned hospital visits after colonoscopy (per 1,000 colonoscopies)Unplanned return visits | 13.2 (9.9 to 17.4) · 702 cases | No different | Jan 2022 – Dec 2024 |
| Ratio of unplanned hospital visits after hospital outpatient surgeryUnplanned return visits | 1 (0.7 to 1.4) · 195 cases | No different | Jan 2024 – Dec 2024 |
What patients said (4,032 patients answered, 29% of those asked)
| Cleanliness | 3 |
| Nurse communication | 3 |
| Doctor communication | 3 |
| Communication about medicines | 3 |
| Discharge information | 2 |
| Overall hospital rating | 3 |
| Quietness | 2 |
| Recommend hospital | 4 |
| Room was "always" clean | 70% |
| Nurses "always" communicated well | 73% |
| Doctors "always" communicated well | 76% |
| Staff "always" explained | 57% |
| Yes, staff "did" give patients this information | 82% |
| Yes, staff "did" give patients information about help after discharge | 82% |
| Doctors "always" explained things so they could understand | 71% |
| Doctors "always" listened carefully | 74% |
| Doctors "always" treated them with courtesy and respect | 82% |
| Patients who gave a rating of "9" or "10" (high) | 67% |
| Staff "always" explained new medications | 71% |
| Nurses "always" explained things so they could understand | 71% |
| Nurses "always" listened carefully | 69% |
| Nurses "always" treated them with courtesy and respect | 80% |
| "Always" quiet at night | 43% |
| "YES", patients would definitely recommend the hospital | 70% |
| Staff "always" explained possible side effects | 44% |
| Yes, staff "did" give patients information about possible symptoms | 83% |
Original Medicare doctor bills
$15,657
Medicare paid this office $15,657 for 120 people.
This is what Medicare paid the clinician — not Medicare Advantage, and not the pharmacy.
| Subsequent hospital care with moderate levelof medical decision making at least 35 minutes | 40 | $4,889 | $70 |
| Initial hospital care with straightforward or low-level medical decision making at least 55 minutes | 33 | $3,360 | $102 |
| Subsequent hospital care with straightforward or low level of medical decision making, per day at least 25 minutes | 29 | $1,546 | $44 |
| Hospital discharge day management, 30 minutes or less | 15 | $1,120 | $75 |
| Initial hospital care with straightforward or low level of medical decision making, per day at least 40 minutes | 12 | $884 | $74 |
Procedures Medicare counted
| Removal of tissue | 1-10 | None |
| Upper gastrointestinal (GI) endoscopy for acid reflux | 1-10 | None |
Who their Medicare patients are
120 Original Medicare patients in 2024. Average age 77 · Under 65 13% · 85 and older 26% · Women 55% · Also on Medicaid 51% · Health risk score 1.74. Above the middle of the specialty; the typical general surgery clinician is at 1.69.
Conditions among them: High blood pressure 75% · Depression 42% · Diabetes 41% · Dementia 40% · Stroke 34% · Coronary heart disease 31% · Atrial fibrillation 28% · Chronic kidney disease 25% · Heart failure 23% · Cancer 23% · COPD 18%.
The office billed $169,181, Medicare allowed $20,350 and paid $15,657; for 190 services of 19 kinds.
Original Medicare patients only. A risk score of 1.0 is the average Medicare patient; higher means sicker. Any count under 11 is hidden.
Year by year
| 2024 | 120 | 190 | 77 | 1.74 | $169,181 | $15,657 |
| 2023 | 104 | 190 | 75 | 2.03 | $205,990 | $22,869 |
| 2022 | 107 | 235 | 75 | 1.40 | $189,956 | $20,994 |
| 2021 | 59 | 100 | 76 | 2.19 | $118,537 | $12,983 |
| 2020 | 95 | 173 | 73 | 2.40 | $119,872 | $14,061 |
| 2019 | 135 | 264 | 74 | 2.03 | $189,770 | $24,705 |
| 2018 | 138 | 253 | 74 | 1.86 | $196,767 | $27,982 |
| 2017 | 114 | 217 | 70 | 2.44 | $161,115 | $23,137 |
| 2016 | 110 | 242 | 68 | 1.83 | $181,125 | $25,168 |
| 2015 | 90 | 158 | 69 | 2.07 | $124,492 | $17,959 |
| 2014 | 101 | 216 | 68 | 1.73 | $166,617 | $26,079 |
Original Medicare only. A service billed for fewer than 11 people in a year is hidden, so the lines can add up to less than the year's total.
See the services billed each year
2023: 5 services
| Subsequent hospital care with moderate levelof medical decision making at least 35 minutes | 29 | $4,724 | $74 |
| Initial hospital care with straightforward or low-level medical decision making at least 55 minutes | 26 | $3,199 | $123 |
| Subsequent hospital care with straightforward or low level of medical decision making, per day at least 25 minutes | 26 | $1,852 | $45 |
| Initial hospital care with straightforward or low level of medical decision making, per day at least 40 minutes | 21 | $1,739 | $79 |
| Hospital discharge day management, 30 minutes or less | 14 | $1,120 | $80 |
2022: 5 services
| Subsequent hospital care with moderate levelof medical decision making at least 35 minutes | 31 | $5,011 | $80 |
| Initial hospital care with straightforward or low-level medical decision making at least 55 minutes | 24 | $3,741 | $150 |
| Subsequent hospital care with straightforward or low level of medical decision making, per day at least 25 minutes | 43 | $3,636 | $41 |
| Initial hospital care with straightforward or low level of medical decision making, per day at least 40 minutes | 15 | $1,637 | $102 |
| Hospital discharge day management, 30 minutes or less | 18 | $1,343 | $75 |
2021: 2 services
| Initial hospital care with straightforward or low-level medical decision making at least 55 minutes | 19 | $2,724 | $143 |
| Subsequent hospital care with straightforward or low level of medical decision making, per day at least 25 minutes | 12 | $1,008 | $44 |
2020: 4 services
| Subsequent hospital care with straightforward or low level of medical decision making, per day at least 25 minutes | 39 | $3,340 | $40 |
| Initial hospital care with straightforward or low-level medical decision making at least 55 minutes | 20 | $3,013 | $151 |
| Hospital discharge day management, 30 minutes or less | 20 | $1,564 | $78 |
| Initial hospital care with straightforward or low level of medical decision making, per day at least 40 minutes | 12 | $1,245 | $104 |
2019: 5 services
| Initial hospital care with straightforward or low-level medical decision making at least 55 minutes | 32 | $3,976 | $124 |
| Subsequent hospital care with straightforward or low level of medical decision making, per day at least 25 minutes | 48 | $3,887 | $36 |
| Hospital discharge day management, 30 minutes or less | 20 | $1,356 | $68 |
| Initial hospital care with straightforward or low level of medical decision making, per day at least 40 minutes | 14 | $1,277 | $91 |
| Short return visit | 16 | $418 | $23 |
2018: 6 services
| Initial hospital care with straightforward or low-level medical decision making at least 55 minutes | 32 | $3,911 | $122 |
| Subsequent hospital care with straightforward or low level of medical decision making, per day at least 25 minutes | 45 | $2,798 | $35 |
| Initial hospital care with straightforward or low level of medical decision making, per day at least 40 minutes | 21 | $1,886 | $90 |
| Hospital discharge day management, 30 minutes or less | 22 | $1,471 | $67 |
| Subsequent hospital care with moderate levelof medical decision making at least 35 minutes | 11 | $915 | $65 |
| Short return visit | 11 | $341 | $23 |
2017: 6 services
| Subsequent hospital care with moderate levelof medical decision making at least 35 minutes | 22 | $2,953 | $63 |
| Initial hospital care with moderate level of medical decision making at least 75 minutes | 11 | $1,934 | $176 |
| Initial hospital care with straightforward or low level of medical decision making, per day at least 40 minutes | 21 | $1,914 | $87 |
| Subsequent hospital care with straightforward or low level of medical decision making, per day at least 25 minutes | 25 | $1,601 | $33 |
| Hospital discharge day management, 30 minutes or less | 12 | $771 | $64 |
| Short return visit (20+ min) | 15 | $508 | $32 |
2016: 5 services
| Subsequent hospital care with moderate levelof medical decision making at least 35 minutes | 30 | $4,537 | $63 |
| Initial hospital care with moderate level of medical decision making at least 75 minutes | 15 | $2,826 | $177 |
| Subsequent hospital care with straightforward or low level of medical decision making, per day at least 25 minutes | 29 | $2,290 | $34 |
| Initial hospital care with straightforward or low level of medical decision making, per day at least 40 minutes | 11 | $1,049 | $87 |
| Short return visit (20+ min) | 17 | $641 | $38 |
2015: 6 services
| Subsequent hospital care with moderate levelof medical decision making at least 35 minutes | 22 | $2,209 | $63 |
| Initial hospital care with moderate level of medical decision making at least 75 minutes | 12 | $2,118 | $176 |
| Initial hospital care with straightforward or low level of medical decision making, per day at least 40 minutes | 15 | $1,368 | $85 |
| Subsequent hospital care with straightforward or low level of medical decision making, per day at least 25 minutes | 13 | $815 | $33 |
| Short return visit (20+ min) | 18 | $527 | $29 |
| Short return visit | 11 | $325 | $22 |
2014: 5 services
| Subsequent hospital care with moderate levelof medical decision making at least 35 minutes | 23 | $3,010 | $64 |
| Subsequent hospital care with straightforward or low level of medical decision making, per day at least 25 minutes | 21 | $2,082 | $35 |
| Initial hospital care with moderate level of medical decision making at least 75 minutes | 11 | $1,973 | $179 |
| Initial hospital care with straightforward or low level of medical decision making, per day at least 40 minutes | 16 | $1,428 | $89 |
| Short return visit (20+ min) | 18 | $797 | $44 |
Medicaid work
$2,274 in 2024
Medicaid paid $2,274 for 98 billed services this clinician did in 2024, up to 18 people in a month for one service.
Medicaid and CHIP claims where this clinician did the service, fee-for-service and managed care together. Any month with fewer than 11 patients is hidden, so small Medicaid practices undercount.
| SBSQ HOSPITAL IP/OBS CARE MOD MDM 35 MINUTES | 73 | $1,429 |
| 1ST HOSPITAL IP/OBS CARE MODERATE MDM 55 MINUTES | 25 | $844 |
| 2024 | 98 | 2 | 18 | $2,274 |
| 2023 | 145 | 2 | 17 | $2,487 |
| 2022 | 131 | 3 | 18 | $2,381 |
| 2021 | 14 | 1 | 14 | $887 |
| 2020 | 34 | 2 | 14 | $936 |
| 2019 | 203 | 2 | 19 | $4,916 |
| 2018 | 124 | 2 | 19 | $2,474 |
See the largest Medicaid services in earlier years
2023
| SBSQ HOSPITAL IP/OBS CARE MOD MDM 35 MINUTES | 128 | $2,245 |
| SBSQ HOSPITAL IP/OBS CARE SF/LOW MDM 25 MINUTES | 17 | $242 |
2022
| SBSQ HOSPITAL IP/OBS CARE MOD MDM 35 MINUTES | 67 | $1,312 |
| SBSQ HOSPITAL IP/OBS CARE SF/LOW MDM 25 MINUTES | 49 | $779 |
| Hospital inpatient or observation discharge day management; 30 minutes or less on the date of the encounter | 15 | $290 |
2021
| 1ST HOSPITAL IP/OBS CARE MODERATE MDM 55 MINUTES | 14 | $887 |
2020
| 1ST HOSPITAL IP/OBS CARE MODERATE MDM 55 MINUTES | 12 | $513 |
| SBSQ HOSPITAL IP/OBS CARE SF/LOW MDM 25 MINUTES | 22 | $422 |
2019
| SBSQ HOSPITAL IP/OBS CARE SF/LOW MDM 25 MINUTES | 160 | $2,989 |
| 1ST HOSPITAL IP/OBS CARE MODERATE MDM 55 MINUTES | 43 | $1,927 |
2018
| SBSQ HOSPITAL IP/OBS CARE SF/LOW MDM 25 MINUTES | 110 | $1,584 |
| 1ST HOSPITAL IP/OBS CARE MODERATE MDM 55 MINUTES | 14 | $890 |
Checkups this office reported
Medicare did not publish checkup rates for this clinician.
- Medicare’s overall office score
- 80.6 / 100
- Scores the office’s reporting and systems. It is not a grade for how the doctor treats you.
Professional record
- NPI
- 1831331578
- Licence
- CA A116687California A116687: Current · expires 2028-08-31
- Trained
- Rush Medical College of Rush University, 2005
- Gender
- Female
More record details
- Sole proprietor
- Yes
- Taxonomy
- Federal specialty code 2086S0102X (2086S0102X)
- Mailing address
- 300 Pasteur Dr, Stanford, CA, 94305
- NPI first listed
- 2009-03-26
- NPI last updated
- 2012-10-30
This is when the NPI record was last certified, not a medical board exam.