Jennifer Carroll, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

214505 Issued in NY

Practice address

322 Lake Ave
Rochester, NY 14608-1017

Phone

(585) 254-6480

Fax

(585) 254-1092

NPI assigned

Jul 20, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in CA, MA2 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

Specialty

Family Practice

Education

University of Connecticut School of Medicine, 1996

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Needham Wellesley Family Medicine PCGroup PAC ID 6507982873, 9 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Newton-Wellesley Hospital Hospital, Newton, MA, CCN 220101

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• Needham Wellesley Family Medicine PC

  • Clinic/Center
  • Wellesley Hills, MA
  • NPI 1679890164
  Medicare reassignment Care Compare group NPD
• Mobile Medical Team International

  • Primary Care Clinic/Center
  • Port Huron, MI
  • NPI 1558120436

  CA

  Medicare reassignment NPD

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

• Newton-Wellesley Hospital

  • General Acute Care Hospital
  • Newton, MA
  • NPI 1992737761
  Care Compare affiliation

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

{
    "created_epoch": "1153353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1639199797",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "480 GENESEE ST",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146113634",
            "telephone_number": "585-254-6480",
            "fax_number": "585-254-1092"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "322 LAKE AVE",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146081017",
            "telephone_number": "585-254-6480",
            "fax_number": "585-254-1092"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARROLL",
        "first_name": "JENNIFER",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-20",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "214505",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "214505",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERRED CARE",
            "identifier": "103401BF",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Alexandra Grace Carroll, MA
• Ashley Marie Carroll, PA
• Baylee Carroll, RD
• Christine Carroll, RN
• James E Carroll, P.A.
• Louise Carroll, M.D.
• Mandy Carroll, LPN
• Roger A Carroll, DDS
• Sean Martin Carroll
• Susan Carroll, LPN

• Family Medicine Physician in Rochester, NY
• Providers in Rochester, NY by specialty
• Family Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.