Clifford Carrol, M.D.

Primary specialty

Gastroenterology PhysicianTaxonomy code 207RG0100X

License

MD476546 Issued in PA

Practice address

601 Park St
Honesdale, PA 18431-1498

Phone

(570) 253-8185

NPI assigned

Sep 25, 2006

Last updated

May 9, 2022By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in PA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Gastroenterology

Education

Other, 1987

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Wayne Memorial HospitalGroup PAC ID 4082522149, 52 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Wayne Memorial Hospital Hospital, Honesdale, PA, CCN 390125

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: clifford.carrol.1@30200.direct.athenahealth.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Wayne Memorial Hospital

  • General Acute Care Hospital
  • Honesdale, PA
  • NPI 1124026182

  Gastroenterology

  Medicare reassignment Care Compare group NPD
• Great West Medical Associates Carrol LLP

  dba Great West Medical Associates

  • Gastroenterology Physician
  • Las Vegas, NV
  • NPI 1750556940
  Authorized official Same address or phone
• Wayne Memorial Hospital

  • General Acute Care Hospital
  • Honesdale, PA
  • NPI 1649573023
  NPD
• Carrera Professinal Services PLLC

  • Gastroenterology Physician
  • Las Vegas, NV
  • NPI 1770816647
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Wayne Memorial Hospital

  • General Acute Care Hospital
  • Honesdale, PA
  • NPI 1124026182
  Care Compare affiliation

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

{
    "created_epoch": "1159142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652054400000",
    "number": "1023119138",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 34795",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891334795",
            "telephone_number": "702-220-9865",
            "fax_number": "702-251-8196"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 PARK ST",
            "city": "HONESDALE",
            "state": "PA",
            "postal_code": "184311498",
            "telephone_number": "570-253-8185"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1698 E McAndrews Rd Ste 170",
            "address_purpose": "LOCATION",
            "city": "Medford",
            "state": "OR",
            "postal_code": "975045590",
            "country_code": "US",
            "telephone_number": "541-732-8500",
            "fax_number": "541-732-8501",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3150 N Tenaya Way Ste 525",
            "address_purpose": "LOCATION",
            "city": "Las Vegas",
            "state": "NV",
            "postal_code": "891280465",
            "country_code": "US",
            "telephone_number": "702-220-9865",
            "fax_number": "702-251-8196",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CARROL",
        "first_name": "CLIFFORD",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-25",
        "last_updated": "2022-05-09",
        "certification_date": "2022-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "OR",
            "license": "MD153344",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "NV",
            "license": "8160",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "PA",
            "license": "MD476546",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Linda Helen Bryan, O.T.
• Natalie Suzanne Burns, LPC
• Billie Jeanne Burry, PHD, CRNP, FNP-BC
• Michael Cory Campbell, MD
• Carl J. Milks, MD PC
• David J Caucci, MD
• Center for Community Resources, Inc.
• Center for Community Resources, Inc.
• Courtney Anne Chapman
• Darla Marie Cherrick, LSW

• Gastroenterology Physician in Honesdale, PA
• Providers in Honesdale, PA by specialty
• Gastroenterology Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2022; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.