NPIMap

Individual provider Active NPI

Madeline Mae Carroll, PA-C

  • Medical Physician Assistant
  • Colonial Heights, VA
National Provider Identifier
1447007547
Registry record updated Jul 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
0110010031 Issued in VA
Practice address
445 Charles H Dimmock Pkwy Ste 100
Colonial Heights, VA 23834-2990
Phone
(804) 520-1764
NPI assigned
May 6, 2024
Last updated
Jul 9, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 9, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 0110010031 VA
Medical Physician Assistant 363AM0700X 0110010031 VA Primary

Addresses

Primary practice location

445 Charles H Dimmock Pkwy Ste 100
Colonial Heights, VA 23834-2990

Mailing address

1024 Stratem CT
Virginia Beach, VA 23451-5977
Phone (757) 663-1934

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240801002927 VA Practitioner - Physician Assistant 9436696937 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
James River Cardiology, LLCGroup PAC ID 0941499594, 49 clinicians

Practice addresses (Care Compare)

445 Charles H Dimmock Pkwy
Suite 100
Colonial Heights, VA 23834-2990
Phone (804) 520-1764

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
0110010031VAMDMedical Physician Assistant

Interoperability endpoints

  • Direct secure messaging: madeline.carroll.1@31267.direct.athenahealth.com

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 14

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

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1714953600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720483200000",
    "number": "1447007547",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1024 STRATEM CT",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234515977",
            "telephone_number": "757-663-1934"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "445 CHARLES H DIMMOCK PKWY STE 100",
            "city": "COLONIAL HEIGHTS",
            "state": "VA",
            "postal_code": "238342990",
            "telephone_number": "804-520-1764"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARROLL",
        "first_name": "MADELINE",
        "middle_name": "MAE",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-05-06",
        "last_updated": "2024-07-09",
        "certification_date": "2024-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "VA",
            "license": "0110010031",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "VA",
            "license": "0110010031",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Colonial Heights, VA

Sources for this page

Verify at the official NPI Registry.