Individual provider Active NPI

Colleen Carroll, CNP

  • Primary Care Nurse Practitioner
  • Cleveland, OH
National Provider Identifier
1053054320
Registry record updated Apr 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
F02220369 Issued in OH
Practice address
11100 Euclid Ave
Cleveland, OH 44106-1716
Phone
(440) 465-0898
NPI assigned
Apr 15, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 15, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Nurse Practitioner 363LP2300X F02220369 OH Primary

Addresses

Primary practice location

11100 Euclid Ave
Cleveland, OH 44106-1716

Mailing address

1343 W 65TH St
Cleveland, OH 44102-2109
Phone (440) 465-0898

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address Colleen.Carroll@UHHospitals.org Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220428001569 OH Practitioner - Nurse Practitioner 2466849013 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
University Hospitals Medical Group IncGroup PAC ID 4789682493, 2,248 clinicians

Practice addresses (Care Compare)

11100 Euclid Ave
Cleveland, OH 44106-1716

29325 Health Campus Dr
Suite 1
Westlake, OH 44145-8201
Phone (216) 368-7967

3909 Orange PL
Suite 1100
Beachwood, OH 44122-4480
Phone (216) 896-1755

Hospital & facility affiliations

  • University Hospital Home Care Services, Inc Home health agency, Warrensville HTS, OH, CCN 367424
  • Uh Cleveland Medical Center Hospital, Cleveland, OH, CCN 360137

Merit-based Incentive Payment System (MIPS)

Final score
81.19 of 100Reported as group
Quality
63.13
Promoting interoperability
100
Improvement activities
40
Cost
74.18

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Practitioner, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
F02220369OHMDPrimary Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
University Hospitals Medical Group Inc CurrentSince Apr 24, 2022 Accepting new patients
Multicare Health System Past Accepting new patients

Locations

2075 Healthway Dr
Ste 2
Avon, OH 44011
Phone (440) 508-2669

8055 Mayfield Rd
Ste 105
Chesterland, OH 44026
Phone (440) 214-8024

11100 Euclid Ave
Cleveland Heights, OH 44106

Interoperability endpoints

  • Direct secure messaging: ccarroll41463@ehrdirect.uhhospitals.org
  • Direct secure messaging: colleen.carroll@uhhospitals.org

Organizations & group practices 2

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.

Hospital & facility affiliations 5

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

NPI Registry JSON

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

{
    "created_epoch": "1649980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649980800000",
    "number": "1053054320",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1343 W 65TH ST",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441022109",
            "telephone_number": "440-465-0898"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11100 EUCLID AVE",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441061716",
            "telephone_number": "440-465-0898"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARROLL",
        "first_name": "COLLEEN",
        "credential": "CNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-04-15",
        "last_updated": "2022-04-15",
        "certification_date": "2022-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "OH",
            "license": "F02220369",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Colleen.Carroll@UHHospitals.org",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Email",
            "address_1": "11100 Euclid Ave",
            "city": "Cleveland",
            "state": "OH",
            "country_code": "US",
            "postal_code": "441061716",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Cleveland, OH

Sources for this page

Verify at the official NPI Registry.