Paul Samuel Decarlo Jr., D.D.S., P.A.

Primary specialty

DentistTaxonomy code 122300000X

License

5468 Issued in FL

Practice address

47 Barkley Cir
Fort Myers, FL 33907-7531

Phone

(239) 936-5252

NPI assigned

Nov 7, 2008

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NC

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• East Carolina University

  dba ECU Physicians

  • Family Medicine Physician
  • Greenville, NC
  • NPI 1972551919
  Medicare reassignment NPD
• Paul S Decarlo Jr. D.D.S., P.a.

  • General Practice Dentistry
  • Fort Myers, FL
  • NPI 1457562241
  NPD (past) Authorized official
• East Carolina University

  • Internal Medicine Physician
  • Greenville, NC
  • NPI 1043260474
  NPD
• East Carolina University

  dba ECU School of Dental Medicine CSLC Ahoskie

  • Dentist
  • Ahoskie, NC
  • NPI 1275806762
  NPD

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

{
    "created_epoch": "1226016000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1226016000000",
    "number": "1013161736",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "47 BARKLEY CIR",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339077531",
            "telephone_number": "239-936-5252"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "47 BARKLEY CIR",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339077531",
            "telephone_number": "239-936-5252"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DECARLO",
        "first_name": "PAUL",
        "middle_name": "SAMUEL",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "D.D.S., P.A.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-11-07",
        "last_updated": "2008-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "5468",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mark Debenedictis
• Lori Marie Deblasi, DPM
• Petra Debolt, A.R.N.P.
• Kimberly Debow, APRN
• Debra Todd Black, D.O., P.a.
• Joaquina Decembre
• Matthew Daniel Dechene, RN
• Sarah Decker
• Dedicated Senior Medical Centers of Florida, LLC (Dedicated Senior Medical Center Boardwalk)
• Dedicated Senior Medical Centers of Florida, LLC (Dedicated Senior Medical Center Majorca Palms)

• Dentist in Fort Myers, FL
• Providers in Fort Myers, FL by specialty
• Dentist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.