Matthew L. Carroll, P.A.

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

3366 Issued in TN

Practice address

1400 S Germantown Rd
Germantown, TN 38138-2205

Phone

(901) 759-3100

Fax

(901) 759-3196

NPI assigned

Jul 19, 2012

Sex

Male

Sole proprietor

No

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

Specialties & licenses 6

Addresses

Other identifiers 5

Medicare fee-for-service enrollment

Enrolled in TN, MS2 enrollments

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 2

Specialty

Physician Assistant

Education

Other, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Campbell Clinic, PCGroup PAC ID 9638082076, 229 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Baptist Memorial Hospital Hospital, Memphis, TN, CCN 440048
• Methodist Hospitals of Memphis Hospital, Memphis, TN, CCN 440049
• Baptist Memorial Hospital Tipton Hospital, Covington, TN, CCN 440131

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: matthew.carroll.1@1366.direct.athenahealth.com
• FHIR API: https://api.platform.athenahealth.com/1366/brand/1/csg/1/fhir/r4
• Direct secure messaging: mcarroll30197@mlh.direct-ci.com

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.

• Campbell Clinic, PC

  • Orthopaedic Surgery Physician
  • Germantown, TN
  • NPI 1003835141

  MS, Physician Assistant

  Medicare reassignment Care Compare group NPD
• Carr PLLC

  • Emergency Medicine Physician
  • Brentwood, TN
  • NPI 1548677610

  MS

  Medicare reassignment
• Emergency Coverage Services, PC

  • Nurse Practitioner
  • Lawrenceburg, TN
  • NPI 1053351593
  Medicare reassignment
• Emergency Coverage, LLC

  • Family Medicine Physician
  • Newport, TN
  • NPI 1427005008
  Medicare reassignment
• Southeastern Emergency Services P C

  • Nurse Practitioner
  • Athens, TN
  • NPI 1669414264
  Medicare reassignment
• T M Carr MD PC

  • Emergency Medicine Physician
  • Dyersburg, TN
  • NPI 1992706097
  Medicare reassignment
• Southeastern Emergency Physicians LLC

  • Emergency Medicine Physician
  • Maysville, KY
  • NPI 1356379382

  MS, TN

  Medicare reassignment
• Campbell Clinic PC

  • Durable Medical Equipment & Medical Supplies
  • Carthage, TN
  • NPI 1669366068
  NPD
• Campbell Clinic

  • Magnetic Resonance Imaging (MRI) Clinic/Center
  • Germantown, TN
  • NPI 1588619944
  NPD (past)
• CC Bpci PLC

  • Orthopaedic Surgery Physician
  • Germantown, TN
  • NPI 1881387330
  NPD (past)
• Acs Emergency Physicians of SC PC

  • Emergency Medicine Physician
  • Beaufort, SC
  • NPI 1124355375

  Physician Assistant

  NPD (past)
• Beaufort Emergency Medicine, PA

  • Emergency Medicine Physician
  • Beaufort, SC
  • NPI 1659460004
  NPD (past)

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

• Baptist Memorial Hospital

  • General Acute Care Hospital
  • Memphis, TN
  • NPI 1578527172
  Care Compare affiliation
• Baptist Memorial Hospital-Tipton

  • General Acute Care Hospital
  • Covington, TN
  • NPI 1316901937
  Care Compare affiliation
• Methodist Healthcare - Memphis Hospitals

  • Children's Hospital
  • Memphis, TN
  • NPI 1386709871
  Care Compare affiliation
• Methodist Healthcare - Memphis Hospitals

  • General Acute Care Hospital
  • Memphis, TN
  • NPI 1558365890
  Care Compare affiliation
• Methodist Healthcare - Memphis Hospitals

  • Children's Hospital
  • Germantown, TN
  • NPI 1649654450
  Care Compare affiliation

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

{
    "created_epoch": "1342656000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665100800000",
    "number": "1346595014",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 S GERMANTOWN RD",
            "city": "GERMANTOWN",
            "state": "TN",
            "postal_code": "381382205",
            "telephone_number": "901-759-3100",
            "fax_number": "901-759-3196"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 S GERMANTOWN RD",
            "city": "GERMANTOWN",
            "state": "TN",
            "postal_code": "381382205",
            "telephone_number": "901-759-3100",
            "fax_number": "901-759-3196"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARROLL",
        "first_name": "MATTHEW",
        "middle_name": "L.",
        "name_prefix": "Mr.",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-07-19",
        "last_updated": "2022-10-07",
        "certification_date": "2022-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "SC",
            "license": "MPA.1778.TL",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OR",
            "license": "PA180137",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MS",
            "license": "PA00386",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TN",
            "license": "3336",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TN",
            "license": "3366",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "LA",
            "license": "200682",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q031131",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "07004261",
            "state": "MS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCCPA",
            "identifier": "1102675",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2351991",
            "state": "LA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SOUTH CAROLINA PA LICENSE",
            "identifier": "MPA.1778.TL",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Patrick Cardosi
• Allison Grace Carmichael, OT
• Jamie T. Carnathan, P.T.
• Carol I. Lynn, MD Gynecology, PLLC
• Jimmy Russell Carroll Jr., M.D.
• Paul C Carruth, MD
• Thomas Clay Carruth, FNP
• Mary E Carson
• Anne Marie Carter, PT
• Louis Caruso, MD

• Physician Assistant in Germantown, TN
• Providers in Germantown, TN by specialty
• Physician Assistant in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.