Active NPI
Carlos A Carmona Jr., D.O.
- Pediatric Critical Care Medicine Physician
- Phoenix, AZ
National Provider Identifier
1023498052
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Critical Care Medicine Physician
- License
- 0102206673
- Practice address
- 1919 E Thomas Rd
Phoenix, AZ 85016-7710 - Phone
- (602) 933-1000
- NPI assigned
- Jun 4, 2015
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anesthesiology Physician | 207L00000X | 94-08685 | KS | |
| Pediatrics Physician | 208000000X | 0102206673 | VA | |
| Pediatric Critical Care Medicine Physician | 2080P0203X | 0102206673 | VA | Primary |
Addresses
Primary practice location
1919 E Thomas Rd
Phoenix, AZ 85016-7710
Mailing address
1919 E Thomas Rd
Phoenix, AZ 85016-7710
Phone (602) 933-1864
Other practice location 1
1008 East Clay Street
Basement Room B-009
Richmond, VA 23298
Phone (804) 314-9457
Other practice location 2
3300 Gallows Rd
Falls Church, VA 22042-3307
Phone (703) 776-4001
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 94-08685 | KS | MD | Anesthesiology Physician |
| 0102206673 | VA | MD | Pediatrics Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1433376000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1719273600000",
"number": "1023498052",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1919 E THOMAS RD",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850167710",
"telephone_number": "602-933-1864"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1919 E THOMAS RD",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850167710",
"telephone_number": "602-933-1000"
}
],
"practiceLocations": [
{
"address_1": "1008 East Clay Street",
"address_2": "Basement Room B-009",
"address_purpose": "LOCATION",
"city": "Richmond",
"state": "VA",
"postal_code": "23298",
"country_code": "US",
"telephone_number": "804-314-9457",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "3300 Gallows Rd",
"address_purpose": "LOCATION",
"city": "Falls Church",
"state": "VA",
"postal_code": "220423307",
"country_code": "US",
"telephone_number": "703-776-4001",
"fax_number": "703-776-7113",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "CARMONA",
"first_name": "CARLOS",
"middle_name": "A",
"name_suffix": "Jr.",
"credential": "D.O.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2015-06-04",
"last_updated": "2024-06-25",
"certification_date": "2024-06-25",
"status": "A"
},
"taxonomies": [
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "KS",
"license": "94-08685",
"primary": false
},
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "VA",
"license": "0102206673",
"primary": false
},
{
"code": "2080P0203X",
"taxonomy_group": "",
"desc": "Pediatrics, Pediatric Critical Care Medicine",
"state": "VA",
"license": "0102206673",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Phoenix, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.