Active NPI
Brenda Carrillo
- Dermatology Physician
- Austin, TX
National Provider Identifier
1477237386
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dermatology Physician
- License
- BP20090173
- Practice address
- 1501 Red River St FL 2
Austin, TX 78712-1845 - Phone
- (512) 495-5555
- NPI assigned
- Jun 12, 2023
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | BP10084429 | TX | |
| Dermatology Physician | 207N00000X | BP20090173 | TX | Primary |
Addresses
Primary practice location
1501 Red River St FL 2
Austin, TX 78712-1845
Mailing address
1501 Red River St FL 2
Austin, TX 78712-1845
Phone (512) 495-5555
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| BP20090173 | TX | MD | Dermatology Physician |
Interoperability endpoints
- brenda.carrillo.1@12704.direct.athenahealth.com
- brenda.carrillo.1@8363.direct.athenahealth.com
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1686528000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1714176000000",
"number": "1477237386",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1501 RED RIVER ST FL 2",
"city": "AUSTIN",
"state": "TX",
"postal_code": "787121845",
"telephone_number": "512-495-5555"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1501 RED RIVER ST FL 2",
"city": "AUSTIN",
"state": "TX",
"postal_code": "787121845",
"telephone_number": "512-495-5555"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CARRILLO",
"first_name": "BRENDA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-06-12",
"last_updated": "2024-04-27",
"certification_date": "2024-04-27",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "TX",
"license": "BP10084429",
"primary": false
},
{
"code": "207N00000X",
"taxonomy_group": "",
"desc": "Dermatology",
"state": "TX",
"license": "BP20090173",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Austin, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2024; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.