NPIMap

Individual provider Active NPI

Peter J Carroll, PA

  • Physician Assistant
  • Fort Carson, CO
National Provider Identifier
1134138878
Registry record updated Feb 1, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
1650 Cochrane Cir
Usameddac
Ft Carson, CO 80913-4613
Phone
(719) 503-7027
NPI assigned
Aug 5, 2006
Last updated
Feb 1, 2017By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 1, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X NU Primary

Addresses

Primary practice location

1650 Cochrane Cir
Usameddac
Ft Carson, CO 80913-4613

Mailing address

1650 Cochrane Cir
Usameddac
Colorado Springs, CO 80913-4613
Phone (719) 503-7027

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
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
I20170316000326 CO Practitioner - Physician Assistant 0446535371 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Poudre Valley Medical Group LLCGroup PAC ID 9638208549, 2,425 clinicians

Practice addresses (Care Compare)

1035 Garden of the Gods Rd
Colorado Springs, CO 80907-9427
Phone (719) 329-1000

13445 Voyager Pkwy
Colorado Springs, CO 80921-7648
Phone (719) 219-0333

16951 E Quincy Ave
Uchmg Primary/Urgent Care Quincy
Aurora, CO 80015-1901
Phone (303) 752-5470

4323 Integrity Ctr PT
Colorado Springs, CO 80917-1683
Phone (719) 591-2558

4404 Barranca LN
Unit 101
Castle Rock, CO 80104-7419
Phone (720) 733-5260

5589 Argonne St
Denver, CO 80249-8989
Phone (720) 516-8805

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Poudre Valley Medical Group, LLC CurrentSince Apr 1, 2017 Accepting new patients
Poudre Valley Medical Group, LLC Past Accepting new patients
Uchealth Community Services Past Accepting new patients

Locations

16951 E Quincy Ave
Aurora, CO 80015
Phone (303) 752-5470

4404 Barranca Ln
Castle Rock, CO 80104
Phone (720) 733-5260

4404 Barranca Ln
Ste 101
Castle Rock, CO 80104
Phone (720) 733-5260

1035 Garden of the Gods Rd
Ste 120
Colorado Springs, CO 80907
Phone (719) 329-1000

13445 Voyager Pkwy
Colorado Springs, CO 80921
Phone (719) 219-0333

2767 Janitell Rd
Colorado Springs, CO 80906
Phone (719) 365-2888

4323 Integrity Center Pt
Colorado Springs, CO 80917
Phone (719) 591-2558

4660 Yosemite St
Ste 100
Denver, CO 80238
Phone (720) 516-8900

5589 Argonne St
Denver, CO 80249
Phone (720) 516-8805

8155 Piney River Ave
Ste 100
Littleton, CO 80125
Phone (303) 265-3370

2695 Rocky Mountain Ave
Ste 150
Loveland, CO 80538
Phone (970) 624-2403

11605 Meridian Market Vw
Ste 184
Peyton, CO 80831
Phone (719) 364-9555

13631 Colorado Blvd
Thornton, CO 80602
Phone (303) 252-2960

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 18

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

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1154736000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1485907200000",
    "number": "1134138878",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1650 COCHRANE CIR",
            "address_2": "USAMEDDAC",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809134613",
            "telephone_number": "719-503-7027"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1650 COCHRANE CIR",
            "address_2": "USAMEDDAC",
            "city": "FT CARSON",
            "state": "CO",
            "postal_code": "809134613",
            "telephone_number": "719-503-7027"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARROLL",
        "first_name": "PETER",
        "middle_name": "J",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-05",
        "last_updated": "2017-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Carson, CO

Sources for this page

Verify at the official NPI Registry.