Carolyn B Carroll, MD

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

CT034871 Issued in CT

Practice address

8 East Main Street
Suite 101
Clinton, CT 06413-2058

Phone

(860) 669-6156

Fax

(860) 664-0285

NPI assigned

Jul 28, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CT

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Dermatology

Education

University of Connecticut School of Medicine, 1989

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Connecticut Skinhealth LLPGroup PAC ID 9638309362, 40 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

100 of 100Reported as group

Promoting interoperability

100

Improvement activities

40

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: carolynbcarroll@ctsh.emadirect.md

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.

• Connecticut Skinhealth LLP

  • Specialist
  • Shelton, CT
  • NPI 1649606385

  CT

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1154044800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1278806400000",
    "number": "1376557199",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8 EAST MAIN STREET",
            "address_2": "SUITE 101",
            "city": "CLINTON",
            "state": "CT",
            "postal_code": "064132058",
            "telephone_number": "860-669-6156",
            "fax_number": "860-664-0285"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8 EAST MAIN STREET",
            "address_2": "SUITE 101",
            "city": "CLINTON",
            "state": "CT",
            "postal_code": "064132058",
            "telephone_number": "860-669-6156",
            "fax_number": "860-664-0285"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARROLL",
        "first_name": "CAROLYN",
        "middle_name": "B",
        "name_prefix": "Mrs.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-28",
        "last_updated": "2010-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "CT",
            "license": "CT034871",
            "primary": true
        },
        {
            "code": "207ND0900X",
            "taxonomy_group": "",
            "desc": "Dermatology, Dermatopathology",
            "state": "CT",
            "license": "CT034871",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001348714",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jeffrey Evan Burzin, DDS
• Scott Cameron, PT
• Desiree Caporaso, LCSW
• Stephanie Rilyn Carey, DCM
• Kenneth Spencer Carlough, DMD
• Child & Adult Orthodontics PC
• Brittany Lee Ciarcia, LCSW
• Clinton Alf Operations LLC
• Clinton Family Dentistry, LLC
• Clinton Human Services

• All providers in Clinton, CT
• Dermatology Physician in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2010; 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.