NPIMap

Individual provider Active NPI

Brian David O'Carroll, DPM

  • Foot & Ankle Surgery Podiatrist
  • Pismo Beach, CA
National Provider Identifier
1336133768
Registry record updated Mar 15, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
E4758 Issued in CA
Practice address
911 Oak Park Blvd
Ste 106
Pismo Beach, CA 93449-3406
Phone
(805) 481-9100
Fax
(805) 481-9199
NPI assigned
Aug 31, 2005
Last updated
Mar 15, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 15, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist 213ES0103X E4758 CA Primary

Addresses

Primary practice location

911 Oak Park Blvd
Ste 106
Pismo Beach, CA 93449-3406

Mailing address

911 Oak Park Blvd
Ste 106
Pismo Beach, CA 93449-3406
Phone (805) 481-9100

Other identifiers 3

IdentifierTypeStateIssuer
000E47580OtherCABLUE SHIELD
E4758OtherCACA MED LICENSE
016004922MedicaidIL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20080506000450 CA Practitioner - Podiatry 7517969769 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
William M. Scholl College of Podiatric Medicine, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

911 Oak Park Blvd
Suite 106
Pismo Beach, CA 93449-3406
Phone (805) 481-9100

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
84.09 of 100Reported as individual
Quality
65.48
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Lower limb (leg) arthroscopy (minimally invasive joint repair)1-10
Melanoma (skin cancer) excision1-10
Removal of tissue337
Removal of skin lesions78
Removal of nail tissue55
Removal or shaving of skin growth1-10
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Brian O'Carroll, D.P.M., Inc. Foot & Ankle Surgery CurrentSince Mar 1, 2011 Accepting new patients
Ocarroll& Associates LLC Foot & Ankle Surgery PastSince Oct 1, 2000 Accepting new patients
Windy City Anesthesia PC Past Accepting new patients
Steve Clark DPM Inc Foot & Ankle Surgery Past Accepting new patients
Dignity Health Past Accepting new patients
Dignity Health Past Accepting new patients
Dignity Community Care Past Accepting new patients

Locations

911 Oak Park Blvd
Ste 106
Pismo Beach, CA 93449
Phone (805) 481-9100

1525 E Main St
#B
Santa Maria, CA 93454
Phone (805) 354-7990

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: brian.o.carroll.1@17052.direct.athenahealth.com
  • FHIR API: https://api.platform.athenahealth.com/17051/brand/1/csg/1/fhir/r4
  • FHIR API: https://api.platform.athenahealth.com/17052/brand/1/csg/1/fhir/r4
  • FHIR API: https://api.platform.athenahealth.com/26381/brand/1/csg/1/fhir/r4

Organizations & group practices 7

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 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": "1125446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1331769600000",
    "number": "1336133768",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "911 OAK PARK BLVD",
            "address_2": "STE 106",
            "city": "PISMO BEACH",
            "state": "CA",
            "postal_code": "934493406",
            "telephone_number": "805-481-9100",
            "fax_number": "805-481-9199"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "911 OAK PARK BLVD",
            "address_2": "STE 106",
            "city": "PISMO BEACH",
            "state": "CA",
            "postal_code": "934493406",
            "telephone_number": "805-481-9100",
            "fax_number": "805-481-9199"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'CARROLL",
        "first_name": "BRIAN",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-31",
        "last_updated": "2012-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "CA",
            "license": "E4758",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "000E47580",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CA MED LICENSE",
            "identifier": "E4758",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "016004922",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pismo Beach, CA

Sources for this page

Verify at the official NPI Registry.