Elaine Marie Carroll, MD

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

36085505 Issued in IL

Practice address

1508 W Reynolds St
Pontiac, IL 61764-2811

Phone

(815) 844-4611

NPI assigned

Feb 15, 2006

Last updated

Apr 20, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 5

Medicare fee-for-service enrollment

Enrolled in IL

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

Specialty

Obstetrics/Gynecology

Education

Other, 1989

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Carle Health Care IncorporatedGroup PAC ID 3577515774, 1,592 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: ecarrollmd345416@carlehiedirect.net
• Direct secure messaging: elainecarroll@beacon.allscriptsdirect.net

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.

• Carle Health Medical Group

  dba Carle Physician Group

  • Internal Medicine Physician
  • Urbana, IL
  • NPI 1154653947
  Medicare reassignment Care Compare group NPD
• Carle West Physician Group Inc

  • Family Medicine Physician
  • Normal, IL
  • NPI 1467074138
  Medicare reassignment NPD
• Richland Memorial Hospital, Inc

  dba Carle Richland Memorial Hospital

  • Critical Access Hospital
  • Olney, IL
  • NPI 1467492124
  Medicare reassignment NPD
• Richland Memorial Hospital, Inc

  • Otolaryngology Physician
  • Olney, IL
  • NPI 1700063179
  NPD
• Richland Memorial Hospital, Inc.

  • Rural Health Clinic/Center
  • West Salem, IL
  • NPI 1922475037
  NPD
• Gibson Community Hospital Association

  dba Gibson Area Hospital and Health Services

  • Critical Access Hospital
  • Gibson City, IL
  • NPI 1114935681
  NPD (past)

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

{
    "created_epoch": "1139961600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650412800000",
    "number": "1598739492",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "611 W PARK ST",
            "city": "URBANA",
            "state": "IL",
            "postal_code": "618012529"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1508 W REYNOLDS ST",
            "city": "PONTIAC",
            "state": "IL",
            "postal_code": "617642811",
            "telephone_number": "815-844-4611"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11123 Parkview Plaza Dr",
            "address_2": "Ste 203",
            "address_purpose": "LOCATION",
            "city": "Fort Wayne",
            "state": "IN",
            "postal_code": "468451707",
            "country_code": "US",
            "telephone_number": "260-266-8380",
            "fax_number": "260-266-8385",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "100 Navarre Pl Ste 4410",
            "address_purpose": "LOCATION",
            "city": "South Bend",
            "state": "IN",
            "postal_code": "46601",
            "country_code": "US",
            "telephone_number": "574-647-1650",
            "fax_number": "574-647-1655",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CARROLL",
        "first_name": "ELAINE",
        "middle_name": "MARIE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-15",
        "last_updated": "2022-04-20",
        "certification_date": "2022-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "IL",
            "license": "36085505",
            "primary": true
        },
        {
            "code": "207VM0101X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Maternal & Fetal Medicine",
            "state": "IN",
            "license": "01076901A",
            "primary": false
        },
        {
            "code": "207VM0101X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Maternal & Fetal Medicine",
            "state": "IL",
            "license": "036085505",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "181980007",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200265610",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN (GROUP)",
            "identifier": "206147",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN (INDIVIDUAL)",
            "identifier": "206147098",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036085505",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Crystal Ann Cargill, APN, NP-BC
• James A Carley, DDS
• Kelsey R Carley, DPT
• Linda G Carley, PT
• Ryan Jason Carley, D.M.D.
• Caitlin Chagoya, MHP
• Champion Fitness Inc
• William Lee Chang II
• Taylor Chase, DPT
• Celcilia M Cipriano

• Obstetrics & Gynecology Physician in Pontiac, IL
• Providers in Pontiac, IL by specialty
• Obstetrics & Gynecology Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2022; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.