Individual provider Active NPI

Daniel John-Martin Carroll, M.D

  • Otolaryngology Physician
  • Avon, IN
National Provider Identifier
1487093399
Registry record updated Mar 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
01092672A Issued in IN
Practice address
7388 Business Center Dr
Avon, IN 46123-6973
Phone
(888) 938-3838
Fax
(888) 919-1083
NPI assigned
Jun 25, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X 64776 MN
Otolaryngology Physician 207Y00000X 01092672A IN Primary

Addresses

Primary practice location

7388 Business Center Dr
Avon, IN 46123-6973

Mailing address

10001 W Innovation Dr Ste 200
Milwaukee, WI 53226-4851
Phone (888) 938-3838

Other practice location 1

9500 Priority Way W Dr
Ste 100
Indianapolis, IN 46240-1472
Phone (888) 938-3838

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240311000240 IN Practitioner - Otolaryngology 2466751755 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Center for Sleep and Nasal Sinus Disorders, LLCGroup PAC ID 7911236039, 9 clinicians

Practice addresses (Care Compare)

7388 Business Ctr Dr
Avon, IN 46123-6973
Phone (888) 938-3838

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
01092672AINMDOtolaryngology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Center for Sleep and Nasal Sinus Disorders, LLC CurrentSince Mar 18, 2024 Accepting new patients
Center for Sleep and Nasal Sinus Disorders, LLC Otolaryngology PastSince Mar 18, 2024 Accepting new patients

Locations

7388 Business Center Dr
Avon, IN 46123
Phone (317) 272-0480

6920 S East St
Ste B
Indianapolis, IN 46227
Phone (317) 497-6880

9500 Priority Way West Dr
#100
Indianapolis, IN 46240

53760 Generations Dr
South Bend, IN 46635
Phone (219) 247-4444

10001 W Innovation Dr
Ste 200
Wauwatosa, WI 53226

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/19820/brand/1/csg/1/fhir/r4

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1372118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709769600000",
    "number": "1487093399",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10001 W INNOVATION DR STE 200",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532264851",
            "telephone_number": "888-938-3838",
            "fax_number": "888-919-1083"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7388 BUSINESS CENTER DR",
            "city": "AVON",
            "state": "IN",
            "postal_code": "461236973",
            "telephone_number": "888-938-3838",
            "fax_number": "888-919-1083"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9500 Priority Way W Dr",
            "address_2": "Ste 100",
            "address_purpose": "LOCATION",
            "city": "Indianapolis",
            "state": "IN",
            "postal_code": "462401472",
            "country_code": "US",
            "telephone_number": "888-938-3838",
            "fax_number": "888-919-1083",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CARROLL",
        "first_name": "DANIEL",
        "middle_name": "JOHN-MARTIN",
        "name_prefix": "Dr.",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-06-25",
        "last_updated": "2024-03-07",
        "certification_date": "2024-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "MN",
            "license": "64776",
            "primary": false
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "IN",
            "license": "01092672A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Avon, IN

Sources for this page

Verify at the official NPI Registry.