Individual provider Active NPI

Bryan Carroll, M.D.

  • Dermatology Physician
  • Westlake, OH
National Provider Identifier
1609087121
Registry record updated Dec 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
35.137019 Issued in OH
Practice address
950 Clague Rd BLDG B
Westlake, OH 44145-1533
Phone
(216) 844-8200
Fax
(440) 250-2022
NPI assigned
May 25, 2007
Last updated
Dec 30, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 30, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X 0101252291 VA
Dermatology Physician 207N00000X 35.137019 OH Primary

Addresses

Primary practice location

950 Clague Rd BLDG B
Westlake, OH 44145-1533

Mailing address

11100 Euclid Ave
Cleveland, OH 44106-1716
Phone (216) 844-1000

Other identifiers 14

IdentifierTypeStateIssuer
10097097OtherVAOPTIMA HEALTH
1609087121OtherVAUNITED HEALTHCARE
PAROtherVAAETNA
-005OtherVATRICARE/CHAMPUS
473606OtherVAANTHEM BC/BS
1609087121MedicaidVA
PAROtherVAMULTIPLAN
5921028MedicaidNC
PAROtherVACORVEL
PAROtherVACIGNA
1609087121OtherVAVIRGINIA PREMIER HEALTH PLAN
1609087121OtherVACOVENTRY HEALTH NETWORK
PAROtherVAUSA MANAGED CARE
PAROtherVAVIRGINIA HEALTH NETWORK

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address bcarroll@uhhospitals.encitedirect.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, OH2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20161112000057 PA Practitioner - Dermatology 7517115777 Reassigns benefits to 1 organization
I20190802002389 OH Practitioner - Dermatology 7517115777 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
Clvlnd Clinic Lerner College of Med of Case WSTN RSV University, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University Hospitals Medical Group IncGroup PAC ID 4789682493, 2,248 clinicians

Practice addresses (Care Compare)

11100 Euclid Ave
Cleveland, OH 44106-1716
Phone (216) 844-1000

Merit-based Incentive Payment System (MIPS)

Final score
81.19 of 100Reported as group
Quality
63.13
Promoting interoperability
100
Improvement activities
40
Cost
74.18

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision80
Removal of skin lesions58
Removal of skin cancer352
Skin biopsy39

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
University of Pittsburgh Physicians CurrentSince Sep 20, 2016 Accepting new patients
University of Pittsburgh Physicians Dermatology CurrentSince Sep 20, 2016 Accepting new patients
University of Pittsburgh Physicians Current Accepting new patients
University Hospitals Medical Group Inc Dermatology CurrentSince Aug 1, 2019 Accepting new patients
Evms Academic Physicians and Surgeons Health Services Foundation Past Accepting new patients

Locations

8055 Mayfield Rd
Ste 105
Chesterland, OH 44026
Phone (440) 214-8024

11100 Euclid Ave
Cleveland Heights, OH 44106

950 Clague Rd
Bldg B
Westlake, OH 44145
Phone (216) 286-6299

3601 5th Ave
Ste 5A
Pittsburgh, PA 15213
Phone (412) 647-4200

Interoperability endpoints

  • Direct secure messaging: bcarroll@uhhospitals.encitedirect.com
  • Direct secure messaging: bcarroll36676@ehrdirect.uhhospitals.org

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1180051200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609286400000",
    "number": "1609087121",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11100 EUCLID AVE",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441061716",
            "telephone_number": "216-844-1000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "950 CLAGUE RD BLDG B",
            "city": "WESTLAKE",
            "state": "OH",
            "postal_code": "441451533",
            "telephone_number": "216-844-8200",
            "fax_number": "440-250-2022"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARROLL",
        "first_name": "BRYAN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-25",
        "last_updated": "2020-12-30",
        "certification_date": "2020-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "VA",
            "license": "0101252291",
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "OH",
            "license": "35.137019",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OPTIMA HEALTH",
            "identifier": "10097097",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "1609087121",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "PAR",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE/CHAMPUS",
            "identifier": "-005",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BC/BS",
            "identifier": "473606",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1609087121",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MULTIPLAN",
            "identifier": "PAR",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5921028",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CORVEL",
            "identifier": "PAR",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "PAR",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VIRGINIA PREMIER HEALTH PLAN",
            "identifier": "1609087121",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COVENTRY HEALTH NETWORK",
            "identifier": "1609087121",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "USA MANAGED CARE",
            "identifier": "PAR",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VIRGINIA HEALTH NETWORK",
            "identifier": "PAR",
            "state": "VA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "bcarroll@uhhospitals.encitedirect.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "950 Clague Rd Bldg B",
            "city": "Westlake",
            "state": "OH",
            "country_code": "US",
            "postal_code": "441451533",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Westlake, OH

Sources for this page

Verify at the official NPI Registry.