NPIMap

Individual provider Active NPI

Jeffrey Carroll, D.O.

  • Orthopaedic Surgery Physician
  • Harper Woods, MI
National Provider Identifier
1255360897
Registry record updated Jan 20, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
5101013938 Issued in MI
Practice address
19701 Vernier Rd
Ste 150
Harper Woods, MI 48225-1467
Phone
(313) 881-4900
Fax
(313) 881-4901
NPI assigned
Jul 3, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 20, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X 5101013938 MI Primary

Addresses

Primary practice location

19701 Vernier Rd
Ste 150
Harper Woods, MI 48225-1467

Mailing address

19701 Vernier Rd
Ste 150
Harper Woods, MI 48225-1467
Phone (313) 881-4900

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20031114000251 MI Practitioner - Orthopedic Surgery 3577477512 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
Michigan State University College of Osteopathic Medicine, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Movement OrthopedicsGroup PAC ID 8022308477, 5 clinicians

Practice addresses (Care Compare)

43475 Dalcoma Dr
Suite 250
Clinton Township, MI 48038-3594
Phone (586) 436-3785

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hip replacement1-10
Knee replacement14
Lower limb (leg) arthroscopy (minimally invasive joint repair)1-10
Upper limb (arm) arthroscopy (minimally invasive joint repair)1-10
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5101013938MIMDOrthopaedic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Movement Physical Therapy LLC CurrentSince May 1, 2018 Accepting new patients
Movement Orthopedics Orthopaedic Surgery CurrentSince Jun 16, 2024 Accepting new patients

Locations

43475 Dalcoma Dr
Ste 250
Clinton Twp, MI 48038
Phone (586) 436-3785

43475 Dalcoma Dr
Ste 160
Clinton Twp, MI 48038
Phone (248) 221-1845

36555 26 Mile Rd
Ste 2400
Lenox, MI 48048
Phone (586) 436-3785

Interoperability endpoints

  • Direct secure messaging: jeffrey.carroll.1@29663.direct.athenahealth.com

Organizations & group practices 5

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.

Hospital & facility affiliations 6

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

NPI Registry JSON

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

{
    "created_epoch": "1151884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1263945600000",
    "number": "1255360897",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19701 VERNIER RD",
            "address_2": "STE 150",
            "city": "HARPER WOODS",
            "state": "MI",
            "postal_code": "482251467",
            "telephone_number": "313-881-4900",
            "fax_number": "313-881-4901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19701 VERNIER RD",
            "address_2": "STE 150",
            "city": "HARPER WOODS",
            "state": "MI",
            "postal_code": "482251467",
            "telephone_number": "313-881-4900",
            "fax_number": "313-881-4901"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARROLL",
        "first_name": "JEFFREY",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-03",
        "last_updated": "2010-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "MI",
            "license": "5101013938",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Harper Woods, MI

Sources for this page

Verify at the official NPI Registry.