NPIMap

Individual provider Active NPI

Christopher John Carbo, DO

  • Addiction Medicine (Family Medicine) Physician
  • Erie, PA
National Provider Identifier
1346248291
Registry record updated Feb 8, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction Medicine (Family Medicine) PhysicianTaxonomy code 207QA0401X
License
OS010329L Issued in PA
Practice address
5515 Peach St
Erie, PA 16509-2603
Phone
(814) 868-8252
Fax
(814) 868-8170
NPI assigned
Jul 13, 2005
Last updated
Feb 8, 2012By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 8, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction Medicine (Family Medicine) Physician 207QA0401X OS010329L PA Primary
Family Medicine Physician 207Q00000X OS010329L PA

Addresses

Primary practice location

5515 Peach St
Erie, PA 16509-2603

Mailing address

PO Box 9471
Erie, PA 16505-8471
Phone (814) 868-8252

Other identifiers 1

IdentifierTypeStateIssuer
0017853230005MedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20050505000309 PA Practitioner - PsychiatryPractitioner - Family PracticePractitioner - Addiction Medicine 4981644317 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
PsychiatryAlso: Addiction Medicine
Education
Philadelphia College of Osteopathic Medicine, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Millcreek Community HospitalGroup PAC ID 8426020173, 67 clinicians

Practice addresses (Care Compare)

5515 Peach St
Erie, PA 16509-2603
Phone (814) 864-4031

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Millcreek Community Hospital CurrentSince Jan 17, 2013 Accepting new patients
Millcreek Community Hospital CurrentSince Jan 17, 2013 Accepting new patients
AMC Health Addiction Medicine Past Accepting new patients

Locations

5515 Peach St
Erie, PA 16509
Phone (814) 864-4031

1306 E 38th St
Erie, PA 16504
Phone (814) 825-3910

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 10

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": "1121212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1328659200000",
    "number": "1346248291",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9471",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165058471",
            "telephone_number": "814-868-8252",
            "fax_number": "814-868-8170"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5515 PEACH ST",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165092603",
            "telephone_number": "814-868-8252",
            "fax_number": "814-868-8170"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARBO",
        "first_name": "CHRISTOPHER",
        "middle_name": "JOHN",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-07-13",
        "last_updated": "2012-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QA0401X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Addiction Medicine",
            "state": "PA",
            "license": "OS010329L",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "OS010329L",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0017853230005",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Erie, PA

Sources for this page

Verify at the official NPI Registry.