Individual provider Active NPI

Michael J Carroll, PA

  • Pain Medicine Physician
  • Greensboro, NC
National Provider Identifier
1235304205
Registry record updated Dec 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine PhysicianTaxonomy code 208VP0000X
License
101656 Issued in NC
Practice address
3402 Battleground Ave
Greensboro, NC 27410
Phone
(336) 883-0029
NPI assigned
Apr 29, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 14, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 101656 NC
Pain Medicine Physician 208VP0000X 101656 NC Primary

Addresses

Primary practice location

3402 Battleground Ave
Greensboro, NC 27410

Mailing address

645 N Main St
High Point, NC 27260-5017
Phone (336) 883-0029

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130313000159 NC Practitioner - Physician Assistant 7315192689 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
88.84 of 100Reported as group
Quality
70.27
Promoting interoperability
98
Improvement activities
40
Cost
77.52

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
101656NCMDPain Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Bethany Medical Center Past Accepting new patients
Direct Diagnostic Services, LLC Past Accepting new patients
Rural Hall Family Practice PA PastSince Jan 17, 2005 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: michael.carroll@phspch.eclinicaldirectplus.com
  • Direct secure messaging: michaelcarroll@bethanymed.allscriptsdirect.net

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1209427200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639440000000",
    "number": "1235304205",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "645 N MAIN ST",
            "city": "HIGH POINT",
            "state": "NC",
            "postal_code": "272605017",
            "telephone_number": "336-883-0029"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3402 BATTLEGROUND AVE",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "27410",
            "telephone_number": "336-883-0029"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARROLL",
        "first_name": "MICHAEL",
        "middle_name": "J",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-04-29",
        "last_updated": "2021-12-14",
        "certification_date": "2021-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "101656",
            "primary": false
        },
        {
            "code": "208VP0000X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Pain Medicine",
            "state": "NC",
            "license": "101656",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greensboro, NC

Sources for this page

Verify at the official NPI Registry.