John T Carroll, DPM
Individual provider Active NPI Foot Surgery Podiatrist · Old Saybrook, CT
NPI 1508946054 · NPPES record last updated May 19, 2016
Key facts
- NPI
- 1508946054
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Foot Surgery Podiatrist 213ES0131X
- License
- 000027 (CT)
- Practice address
- 455 Boston Post Rd Ste 8
Old Saybrook, CT 06475-1554 - Phone
- (860) 510-0502
- Fax
- (860) 510-0551
- NPI assigned
- Oct 17, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 3
Medicare Care Compare profile
- Specialty
- Podiatry
- Education
- Kent State University College of Podiatric Medicine, 1975
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
455 Boston Post Rd
Suite 8
Old Saybrook, CT 06475-1554
Phone (860) 510-0502
Merit-based Incentive Payment System (MIPS)
- Final score
- 0 of 100
- Quality
- 0
- Improvement activities
- 0
- Cost
- 0
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Removal of tissue | 1-10 |
| Removal of skin lesions | 1-10 |
| Removal of nail tissue | 1023 |
| Removal or shaving of skin growth | 415 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CT
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20110106001083 | CT | Practitioner - Podiatry | 4183831894 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| DRS Kierstein & Difrancesca DPM, PC | Sports Medicine | Current |
Accepting new patients |
| John T. Carroll, DPM PC | Foot Surgery | Current |
Accepting new patients |
| DRS Kierstein & Difrancesca DPM, PC | Current |
Accepting new patients |
Locations
5 Case St
Norwich, CT 06360
Phone (860) 889-0022
455 Boston Post Rd
#8
Old Saybrook, CT 06475
Phone (860) 510-0502
455 Boston Post Rd
Ste 8
Old Saybrook, CT 06475
Phone (860) 510-0502
196 Parkway S
#302
Waterford, CT 06385
Phone (860) 447-1488
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Sports Medicine Podiatrist | 213ES0000X | 000027 | CT | |
| Foot Surgery Podiatrist | 213ES0131X | 000027 | CT | Yes |
Addresses
Primary practice location
455 Boston Post Rd Ste 8
Old Saybrook, CT 06475-1554
Mailing address
196 Parkway S 302
Waterford, CT 06385-1234
Phone (860) 447-1488
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 004006276 | Medicaid | CT |
Other providers in Old Saybrook, CT
- Matthew S Cantner
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- Carla Harper, LPC, LLC
- Carolyn Koerner Mangiafico LLC
- Carrie Kolb, LCSW, LLC
- Cartier Optical Inc
- Ernest A Cartier Jr.
- Brandy Cash
- Catherine Catti
- Rachel Coates Cavanna
All providers in Old Saybrook, CT · Foot Surgery Podiatrist in Connecticut
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 19, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.