Individual provider Active NPI

Antoine Lyonel Carre, MD

  • Surgery Physician
  • Campbell, CA
National Provider Identifier
1629263413
Registry record updated Dec 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
A100255 Issued in CA
Practice address
958 La Plata PLZ
Campbell, CA 95008-5941
Phone
(408) 230-6654
NPI assigned
Sep 13, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 1, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X A100255 CA Primary

Addresses

Primary practice location

958 La Plata PLZ
Campbell, CA 95008-5941

Mailing address

958 La Plata PLZ
Campbell, CA 95008-5941
Phone (408) 230-6654

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq Health Information Exchange (HIE) Southern California Permanente Medical Group

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20160503002252 CA Practitioner - Plastic and Reconstructive SurgeryPractitioner - General Surgery 7517266109 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Plastic and Reconstructive SurgeryAlso: General Surgery
Education
University of California, San Francisco School of Medicine, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
City of Hope Medical FoundationGroup PAC ID 3779751656, 964 clinicians

Practice addresses (Care Compare)

5215 Torrance Blvd
Torrance, CA 90503-4009
Phone (310) 750-1715

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
92.8 of 100Reported as group
Quality
78.51
Promoting interoperability
100
Improvement activities
40
Cost
70.37

Procedures performed for Medicare patients

ProcedureNumber of procedures
Mastectomy31
Melanoma (skin cancer) excision1-10
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
100255CAMDOrthodontics and Dentofacial Orthopedic Dentist
A100255CAMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
City of Hope Medical Foundation Surgery CurrentSince May 20, 2024 Accepting new patients
Providence Health System Southern California Past Accepting new patients
Torrance Memorial Medical Center Past Accepting new patients

Locations

1500 Duarte Rd
Duarte, CA 91010
Phone (626) 359-8111

1000 Fivepoint
Irvine, CA 92618
Phone (888) 333-4673

1601 Avocado Ave
Newport Beach, CA 92660
Phone (949) 763-2204

209 Fair Oaks Ave
South Pasadena, CA 91030
Phone (626) 359-8111

5215 Torrance Blvd
Torrance, CA 90503
Phone (310) 316-6190

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: acarre85389@cityofhope.direct-ci.com

Organizations & group practices 3

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": "1189641600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638316800000",
    "number": "1629263413",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "958 LA PLATA PLZ",
            "city": "CAMPBELL",
            "state": "CA",
            "postal_code": "950085941",
            "telephone_number": "408-230-6654"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "958 LA PLATA PLZ",
            "city": "CAMPBELL",
            "state": "CA",
            "postal_code": "950085941",
            "telephone_number": "408-230-6654"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARRE",
        "first_name": "ANTOINE",
        "middle_name": "LYONEL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-09-13",
        "last_updated": "2021-12-01",
        "certification_date": "2021-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "CA",
            "license": "A100255",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
            "affiliation": "Y",
            "endpointDescription": "CAREQUALITY",
            "affiliationName": "Southern California Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "6041 Cadillac Ave",
            "city": "Los Angeles",
            "state": "CA",
            "country_code": "US",
            "postal_code": "900341702",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Campbell, CA

Sources for this page

Verify at the official NPI Registry.