Richard Paul Carroll, M.D.

Primary specialty

SpecialistTaxonomy code 174400000X

License

21566 Issued in MN

Practice address

4887 E Lake Harriet Blvd
Minneapolis, MN 55419-5222

Phone

(612) 325-0317

NPI assigned

Feb 7, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Ophthalmic Plastic and Reconstructive Surgery, P.a.

  • Specialist
  • Minneapolis, MN
  • NPI 1386716157
  NPD (past) Authorized official

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

{
    "created_epoch": "1139270400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1272326400000",
    "number": "1407828007",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4887 E LAKE HARRIET BLVD",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554195222",
            "telephone_number": "612-325-0317"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4887 E LAKE HARRIET BLVD",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554195222",
            "telephone_number": "612-325-0317"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARROLL",
        "first_name": "RICHARD",
        "middle_name": "PAUL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-07",
        "last_updated": "2010-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "MN",
            "license": "21566",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "648872200",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PROVIDER NUMBER",
            "identifier": "6D561CA",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WISCONSIN MA PROVIDER NO.",
            "identifier": "31260500",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Joseph Thomas Carroll, MD
• Judith Tammy Carroll, FNP
• Kenyata Tyeshia Carroll, FNP, CNP
• Kris Carroll
• Molly Kathryn Carroll, MD
• Sara Maree Carroll, REGISTERED NURSE
• Lara Jean Carson, RN
• Linda Frances Carson, M.D.
• Madeline Carson
• Emily Carstens, DPT

• Specialist in Minneapolis, MN
• Providers in Minneapolis, MN by specialty
• Specialist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.