Individual provider Active NPI

Robert Steven Carroll, MD

  • Psychiatry Physician
  • Los Angeles, CA
National Provider Identifier
1639388077
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
CA LIC G032317 Issued in CA
Practice address
1314 Westwood BL
#210
Los Angeles, CA 90024
Phone
(310) 475-2990
NPI assigned
May 22, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X CA LIC G032317 CA Primary

Addresses

Primary practice location

1314 Westwood BL
#210
Los Angeles, CA 90024

Mailing address

1314 Westwood BL
#210
Los Angeles, CA 90024
Phone (310) 475-2990

Other identifiers 1

IdentifierTypeStateIssuer
G032317OtherCA LIC NUMBER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.
Opted out of Medicare
Yes, effective Nov 5, 2020 through Nov 5, 2026

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
CA LIC G032317CAMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Robert Carroll MD a Professional Corporation Psychiatry PastSince Jan 1, 1990 Accepting new patients

Organizations & group practices 1

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": "1179792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1639388077",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1314 WESTWOOD BL",
            "address_2": "#210",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "90024",
            "telephone_number": "310-475-2990"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1314 WESTWOOD BL",
            "address_2": "#210",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "90024",
            "telephone_number": "310-475-2990"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARROLL",
        "first_name": "ROBERT",
        "middle_name": "STEVEN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-22",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "CA LIC G032317",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CA LIC NUMBER",
            "identifier": "G032317",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.