Brian O'Carroll, D.P.M., Inc.

Primary specialty

Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X

License

E4758 Issued in CA

Legal business name

BRIAN O'CARROLL, D.P.M., INC.

Practice address

911 Oak Park Blvd
Ste 106
Pismo Beach, CA 93449-3406

Phone

(805) 481-9100

Fax

(805) 481-9199

NPI assigned

Dec 10, 2010

Last updated

Mar 15, 2012By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Brian David O'Carroll, DPMNPI 1336133768

Title

Owner

Phone

(805) 481-9100

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in CA2 enrollments

Enrollment records 2

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/17051/brand/1/csg/1/fhir/r4

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Brian David O'Carroll, DPM

  • Foot & Ankle Surgery Podiatrist
  • Pismo Beach, CA
  • NPI 1336133768
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1291939200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1331769600000",
    "number": "1427351535",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "911 OAK PARK BLVD",
            "address_2": "STE 106",
            "city": "PISMO BEACH",
            "state": "CA",
            "postal_code": "934493406",
            "telephone_number": "805-481-9100",
            "fax_number": "805-481-9199"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "911 OAK PARK BLVD",
            "address_2": "STE 106",
            "city": "PISMO BEACH",
            "state": "CA",
            "postal_code": "934493406",
            "telephone_number": "805-481-9100",
            "fax_number": "805-481-9199"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRIAN O'CARROLL, D.P.M., INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-12-10",
        "last_updated": "2012-03-15",
        "status": "A",
        "authorized_official_last_name": "O'CARROLL",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_middle_name": "DAVID",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "805-481-9100",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "CA",
            "license": "E4758",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "000E47580",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CA MED LICENSE",
            "identifier": "E4758",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Beth David Counseling Services (Coastal Wellness Center)
• Terrance Bircher
• Linda Bjornson, GNP
• Brain Waves Inc. (Brain Waves)
• Ethan Jeremy Breen, D.O
• Ludmila Burcovschi, NP
• Miriam Burlakovsky, ED.S, BCBA, LEP#4368
• Julie Lynne Butler, PT
• Byron Collier DPM Inc
• Nichole Christine Calderon, RBT

• Foot & Ankle Surgery Podiatrist in Pismo Beach, CA
• Providers in Pismo Beach, CA by specialty
• Foot & Ankle Surgery Podiatrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.