Kathleen MC Carroll

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

4301040947 Issued in MI

Practice address

3601 W 13 Mile Rd
Royal Oak, MI 48073-6712

Phone

(248) 898-6509

Fax

(248) 898-5490

NPI assigned

Mar 24, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Merit-based Incentive Payment System (MIPS)

Final score

89.64 of 100Reported as group

Quality

85.06

Promoting interoperability

100

Improvement activities

40

Cost

77.9

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: kmccarroll3728@direct.beaumont.edu
• Direct secure messaging: kmccarroll1454994@epic00.shdirect.org

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.

• Dr L Reynolds Assoc PC

  • Specialist
  • Southfield, MI
  • NPI 1669423265
  NPD (past)

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

{
    "created_epoch": "1143158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659052800000",
    "number": "1073573051",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26901 BEAUMONT BLVD # 3D",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480333849",
            "telephone_number": "947-522-1952",
            "fax_number": "947-522-0307"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3601 W 13 MILE RD",
            "city": "ROYAL OAK",
            "state": "MI",
            "postal_code": "480736712",
            "telephone_number": "248-898-6509",
            "fax_number": "248-898-5490"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "15959 Hall Rd",
            "address_purpose": "LOCATION",
            "city": "Macomb",
            "state": "MI",
            "postal_code": "480445363",
            "country_code": "US",
            "telephone_number": "248-964-5190",
            "fax_number": "248-964-5199",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "468 Cadieux Rd",
            "address_purpose": "LOCATION",
            "city": "Grosse Pointe",
            "state": "MI",
            "postal_code": "482301507",
            "country_code": "US",
            "telephone_number": "313-473-1833",
            "fax_number": "313-473-6916",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "36555 26 Mile Road",
            "address_2": "Suite 3000",
            "address_purpose": "LOCATION",
            "city": "Lenox Township",
            "state": "MI",
            "postal_code": "48048",
            "country_code": "US",
            "telephone_number": "947-523-4040",
            "fax_number": "947-523-4041",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "36555 26 Mile Road",
            "address_2": "Suite 1400",
            "address_purpose": "LOCATION",
            "city": "Lenox Township",
            "state": "MI",
            "postal_code": "48048",
            "country_code": "US",
            "telephone_number": "947-523-4020",
            "fax_number": "947-523-4021",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "44201 Dequindre Rd",
            "address_purpose": "LOCATION",
            "city": "Troy",
            "state": "MI",
            "postal_code": "480851117",
            "country_code": "US",
            "telephone_number": "248-964-5190",
            "fax_number": "248-964-5199",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "44250 Dequindre Rd",
            "address_purpose": "LOCATION",
            "city": "Sterling Heights",
            "state": "MI",
            "postal_code": "483141002",
            "country_code": "US",
            "telephone_number": "248-964-5190",
            "fax_number": "248-964-5199",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MC CARROLL",
        "first_name": "KATHLEEN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-24",
        "last_updated": "2022-07-29",
        "certification_date": "2022-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MI",
            "license": "4301040947",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4310549",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSM",
            "identifier": "300F362420",
            "state": "MI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kmccarroll3728@direct.beaumont.edu",
            "affiliation": "N",
            "address_1": "15959 Hall Rd",
            "city": "Macomb",
            "state": "MI",
            "country_code": "US",
            "postal_code": "480445363",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Michael Maysura, BSW
• Samia Mazumder, MD
• Julia Maria Mazur, CPNP-PC
• Mary K Mazzara
• Janis Mazzola, NP
• James D MC Cullough, M.D
• Anne MC Neill, CRNA
• Christopher MC Peak
• Lindsi Kai McAlister, NP
• Kristen McBride, MD

• Diagnostic Radiology Physician in Royal Oak, MI
• Providers in Royal Oak, MI by specialty
• Diagnostic Radiology Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• 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.