Active NPI
Noel John M. Carrasco, M.D.
- Pediatrics Physician
- Marana, AZ
National Provider Identifier
1407285307
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 33094
- Practice address
- 12308 N Paseo Penuela
Marana, AZ 85658-4704 - Phone
- (928) 301-4646
- NPI assigned
- Nov 1, 2013
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Neonatal-Perinatal Medicine Physician | 2080N0001X | 33094 | AZ | |
| General Practice Physician | 208D00000X | 33094 | AZ | |
| Pediatrics Physician | 208000000X | 33094 | AZ | Primary |
Addresses
Primary practice location
12308 N Paseo Penuela
Marana, AZ 85658-4704
Mailing address
12090 N Thornydale Rd Ste110 PMB 323
Marana, AZ 85658-4779
Phone (928) 301-4646
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 33094 | AZ | MD | General Practice Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1383264000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1726444800000",
"number": "1407285307",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12090 N THORNYDALE RD STE110 PMB 323",
"city": "MARANA",
"state": "AZ",
"postal_code": "856584779",
"telephone_number": "928-301-4646"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12308 N PASEO PENUELA",
"city": "MARANA",
"state": "AZ",
"postal_code": "856584704",
"telephone_number": "928-301-4646"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CARRASCO",
"first_name": "NOEL",
"middle_name": "JOHN M.",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2013-11-01",
"last_updated": "2024-09-16",
"certification_date": "2024-09-16",
"status": "A"
},
"taxonomies": [
{
"code": "2080N0001X",
"taxonomy_group": "",
"desc": "Pediatrics, Neonatal-Perinatal Medicine",
"state": "AZ",
"license": "33094",
"primary": false
},
{
"code": "208D00000X",
"taxonomy_group": "",
"desc": "General Practice",
"state": "AZ",
"license": "33094",
"primary": false
},
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "AZ",
"license": "33094",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Marana, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.