NPIMap

Individual provider Active NPI

Matthew Bernard Carroll, M.D.

  • Rheumatology Physician
  • Pascagoula, MS
National Provider Identifier
1124247341
Registry record updated May 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rheumatology PhysicianTaxonomy code 207RR0500X
License
23890 Issued in MS
Practice address
3101 Denny Ave Ste 240
Pascagoula, MS 39581-5307
Phone
(228) 696-9995
Fax
(228) 696-9906
NPI assigned
Apr 25, 2007
Last updated
May 2, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 2, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rheumatology Physician 207RR0500X 23890 MS Primary

Addresses

Primary practice location

3101 Denny Ave Ste 240
Pascagoula, MS 39581-5307

Mailing address

2101 Highway 90
Gautier, MS 39553-5340
Phone (228) 497-7576

Other identifiers 1

IdentifierTypeStateIssuer
06688263MedicaidMS

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mcarroll28623@direct.mysrhs.com Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110524000601 MS Practitioner - RheumatologyPractitioner - Internal Medicine 4981880168 Reassigns benefits to 2 organizations
Practice locations: Keesler AFB, MS

Care Compare profile

Medicare Care Compare
Specialty
RheumatologyAlso: Internal Medicine
Education
Uniformed Services Uhs Fe Hebert School of Med, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Singing River Health SystemGroup PAC ID 3870405194, 290 clinicians

Practice addresses (Care Compare)

3603 Bienville Blvd
Ocean Springs, MS 39564-5727
Phone (228) 872-8768

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Singing River Health System CurrentSince Jan 1, 2017 Accepting new patients
Singing River Gulfport CurrentSince Aug 28, 2023 Accepting new patients
Singing River Health System PastSince Jan 1, 2017 Accepting new patients

Locations

967 Cedar Lake Rd
#A
Biloxi, MS 39532
Phone (228) 205-6830

2101 Highway 90
Gautier, MS 39553
Phone (228) 497-7576

350 Cowan Rd
Gulfport, MS 39507
Phone (228) 206-7054

3603 Bienville Blvd
Ste 203
Ocean Springs, MS 39564
Phone (228) 872-8768

3101 Denny Ave
Ste 240
Pascagoula, MS 39581
Phone (228) 696-9995

Interoperability endpoints

  • Direct secure messaging: mcarroll28623@direct.mysrhs.com

Organizations & group practices 3

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.

Hospital & facility affiliations 63

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

View all 63

NPI Registry JSON

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

{
    "created_epoch": "1177459200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651449600000",
    "number": "1124247341",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2101 HIGHWAY 90",
            "city": "GAUTIER",
            "state": "MS",
            "postal_code": "395535340",
            "telephone_number": "228-497-7576",
            "fax_number": "228-497-8869"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3101 DENNY AVE STE 240",
            "city": "PASCAGOULA",
            "state": "MS",
            "postal_code": "395815307",
            "telephone_number": "228-696-9995",
            "fax_number": "228-696-9906"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARROLL",
        "first_name": "MATTHEW",
        "middle_name": "BERNARD",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-25",
        "last_updated": "2022-05-02",
        "certification_date": "2022-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RR0500X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Rheumatology",
            "state": "MS",
            "license": "23890",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "06688263",
            "state": "MS"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mcarroll28623@direct.mysrhs.com",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "3101 Denny Ave Ste 240",
            "city": "Pascagoula",
            "state": "MS",
            "country_code": "US",
            "postal_code": "395815307",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Pascagoula, MS

Sources for this page

Verify at the official NPI Registry.