Michael John Carroll, MS, RDN

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

86101508 Issued in NJ

Practice address

276 Randolph Ave
East Rutherford, NJ 07073-1345

Phone

(201) 739-5023

NPI assigned

Mar 11, 2019

Last updated

Aug 20, 2019By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/IHJHBD
• Direct secure messaging: michael.carroll@direct.hackensackmeridian.org
• Direct secure messaging: michaelj.carroll@hackensackmeridian.org

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.

• Hackensack Meridian Health Medical Group - Complex Care PC

  dba HMHMG Complex Care

  • Internal Medicine Physician
  • Red Bank, NJ
  • NPI 1154379626
  Medicare reassignment NPD
• Hackensack Meridian Health Medical Group - Specialty Care PC

  dba HMHMG Specialty Care

  • Surgical Critical Care Physician
  • Red Bank, NJ
  • NPI 1215989249
  Medicare reassignment NPD
• Hackensack Meridian Health Medical Group - Specialty Care PC

  dba HMMG New Jersey Oral & Maxillofacial Surgery

  • Durable Medical Equipment & Medical Supplies
  • North Bergen, NJ
  • NPI 1215734199
  NPD
• Hackensack Meridian Health Medical Group - Specialty Care PC

  • Psychologist
  • Red Bank, NJ
  • NPI 1609593722
  NPD (past)

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

{
    "created_epoch": "1552262400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566259200000",
    "number": "1114485919",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "276 RANDOLPH AVE",
            "city": "EAST RUTHERFORD",
            "state": "NJ",
            "postal_code": "070731345",
            "telephone_number": "201-739-5023"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "276 RANDOLPH AVE",
            "city": "EAST RUTHERFORD",
            "state": "NJ",
            "postal_code": "070731345",
            "telephone_number": "201-739-5023"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "155 Polifly Road",
            "address_2": "Suite 102",
            "address_purpose": "LOCATION",
            "city": "Hackensack",
            "state": "NJ",
            "postal_code": "076011771",
            "country_code": "US",
            "telephone_number": "551-996-8840",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CARROLL",
        "first_name": "MICHAEL",
        "middle_name": "JOHN",
        "credential": "MS, RDN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-03-11",
        "last_updated": "2019-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "NJ",
            "license": "86101508",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "MichaelJ.Carroll@hackensackmeridian.org",
            "affiliation": "N",
            "address_1": "155 Polifly Road",
            "address_2": "Suite 102",
            "city": "Hackensack",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "076011771",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Borough of East Rutherford
• Michael J Bozan, DC
• Philip Buzzerio, M.S. ATC
• Cambridge Gears LLC
• Carlstadt East Rutherford Board of Education
• Genesis Carvajal, LPN
• Lilibeth Castillo
• City Orthopaedics & Sports Medicine LLC
• John A Colaneri, M.D.
• Elise M Cole, LCSW

• Registered Dietitian in East Rutherford, NJ
• Providers in East Rutherford, NJ by specialty
• Registered Dietitian in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.