Individual provider Active NPI

Edward W Carriere Jr., MD

  • Hospitalist Physician
  • Englewood, CO
National Provider Identifier
1629064571
Registry record updated Nov 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
30907 Issued in CO
Practice address
499 East Hampden
#320
Englewood, CO 80113-2793
Phone
(303) 781-8439
Fax
(303) 788-6115
NPI assigned
Sep 26, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hospitalist Physician 208M00000X 30907 CO Primary

Addresses

Primary practice location

499 East Hampden
#320
Englewood, CO 80113-2793

Mailing address

499 East Hampden
# 320
Englewood, CO 80113-2793
Phone (303) 781-8439

Other identifiers 1

IdentifierTypeStateIssuer
01309079MedicaidCO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
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
I20100922000969 CO Practitioner - Internal Medicine 8527042894 Practice locations: Franktown, CO

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Louisiana State University School of Medicine in Shreveport, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2400 S Russellville Rd
Franktown, CO 80116-8557
Phone (303) 577-1900

Hospital & facility affiliations

  • Heart of the Rockies Regional Medical Center Hospital, Salida, CO, CCN 061322

Merit-based Incentive Payment System (MIPS)

Final score
75.69 of 100Reported as group
Quality
71.4
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
40.82 of 100Reported as group
Quality
9.1
Promoting interoperability
100
Improvement activities
0
Cost
43.64

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
30907COMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Internal Aesthetic Medicine, LLC PastSince Sep 1, 2013 Accepting new patients
Inpatient Medicine Service PC Past Accepting new patients

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1127692800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1194480000000",
    "number": "1629064571",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "499 EAST HAMPDEN",
            "address_2": "# 320",
            "city": "ENGLEWOOD",
            "state": "CO",
            "postal_code": "801132793",
            "telephone_number": "303-781-8439",
            "fax_number": "303-788-6115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "499 EAST HAMPDEN",
            "address_2": "#320",
            "city": "ENGLEWOOD",
            "state": "CO",
            "postal_code": "801132793",
            "telephone_number": "303-781-8439",
            "fax_number": "303-788-6115"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARRIERE",
        "first_name": "EDWARD",
        "middle_name": "W",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-26",
        "last_updated": "2007-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "CO",
            "license": "30907",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01309079",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Englewood, CO

Sources for this page

Verify at the official NPI Registry.