Peter S Carrillo, M.D.

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

35066260C Issued in OH

Practice address

7575 Northcliff Ave 301
Brooklyn, OH 44144-3265

Phone

(330) 425-7806

Fax

(330) 405-3026

NPI assigned

Nov 12, 2006

Last updated

Sep 30, 2015By 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 1

Addresses

Other identifiers 1

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

General SurgeryAlso: Emergency Medicine

Education

Northeastern Ohio University College of Medicine, 1991

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Arvada Health LLCGroup PAC ID 3971027673, 7 clinicians

Xcel Healing LLCGroup PAC ID 4880166651, 4 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/23125/brand/1/csg/1/fhir/r4

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.

• Arvada Health LLC

  dba Xcel Healing

  • Wound Care Registered Nurse
  • Pepper Pike, OH
  • NPI 1144035346
  Medicare reassignment Care Compare group NPD
• Xcel Healing LLC

  • Internal Medicine Physician
  • Green, OH
  • NPI 1134064272
  Medicare reassignment Care Compare group
• Wound Care Consultants LLC

  • Foot & Ankle Surgery Podiatrist
  • Parma, OH
  • NPI 1831495373
  Medicare reassignment NPD
• Clinic Regional Physicians LLC

  • Internal Medicine Physician
  • Beachwood, OH
  • NPI 1043470453

  Surgery

  NPD (past)
• Dennis Grossman M.N., Inc.

  • Internal Medicine Physician
  • Bedford, OH
  • NPI 1962404608
  NPD (past)
• Gagan C Mallik MD Inc

  • Otolaryngology Physician
  • Cleveland, OH
  • NPI 1770687873
  NPD (past)
• Jack Anstandig, M.D., Inc.

  • Neurology Physician
  • Willoughby, OH
  • NPI 1457474330
  NPD (past)

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

{
    "created_epoch": "1163289600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1443571200000",
    "number": "1063583193",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7575 NORTHCLIFF AVE 301",
            "city": "BROOKLYN",
            "state": "OH",
            "postal_code": "441443265",
            "telephone_number": "330-425-7806",
            "fax_number": "330-405-3026"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7575 NORTHCLIFF AVE 301",
            "city": "BROOKLYN",
            "state": "OH",
            "postal_code": "441443265",
            "telephone_number": "330-425-7806",
            "fax_number": "330-405-3026"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARRILLO",
        "first_name": "PETER",
        "middle_name": "S",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-12",
        "last_updated": "2015-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "OH",
            "license": "35066260C",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2164321",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Brooklyn City School District
• Brooklyn Pointe, LLC
• Britlee Brost
• Logan Joesph Bucy
• Helenrae Budzilek
• Jeffrey Scott Castel, D.D.S.
• Carolyn Diane Cates, LISW-S
• Rebekah Maxine Chapnick, MD
• Taniesha Childs
• Josephine Chukwuonye

• Surgery Physician in Brooklyn, OH
• Providers in Brooklyn, OH by specialty
• Surgery Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2015; 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.