Monique Lynette Carroll, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA12299 Issued in TX

Practice address

19114 US Hwy 281 N
San Antonio, TX 78258

Phone

(210) 496-7999

Fax

(210) 494-1666

NPI assigned

Apr 6, 2015

Last updated

Sep 1, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other names 1

• Monique Lynette Greene Former name

Medicare fee-for-service enrollment

Enrolled in DC, TX2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Wellmed Medical Group, PA

  • Internal Medicine Physician
  • San Antonio, TX
  • NPI 1437156486
  Medicare reassignment NPD
• Northridge Behavioral Health PLLC

  • Psychiatry Physician
  • San Antonio, TX
  • NPI 1144788258
  Medicare reassignment
• Wellmed Medical Group, P.a.

  dba WellMed Doctor's Hospital Senior Clinic

  • Family Medicine Physician
  • Corpus Christi, TX
  • NPI 1740588243
  NPD

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

{
    "created_epoch": "1428278400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693526400000",
    "number": "1679968770",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19114 US HWY 281 N",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "78258",
            "telephone_number": "210-496-7999",
            "fax_number": "210-494-1666"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19114 US HWY 281 N",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "78258",
            "telephone_number": "210-496-7999",
            "fax_number": "210-494-1666"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7676 New Hampshire Ave",
            "address_2": "Suite 220A",
            "address_purpose": "LOCATION",
            "city": "Takoma Park",
            "state": "MD",
            "postal_code": "209127512",
            "country_code": "US",
            "telephone_number": "301-431-2972",
            "fax_number": "301-439-0008",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CARROLL",
        "first_name": "MONIQUE",
        "middle_name": "LYNETTE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-04-06",
        "last_updated": "2023-09-01",
        "certification_date": "2023-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MD",
            "license": "C0005631",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "DC",
            "license": "PA031105",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA12299",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MONIQUE",
            "last_name": "GREENE",
            "middle_name": "LYNETTE",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Desiree Carroll
• Elisa F Carroll, M.D.
• Harmony Alexis Carroll
• Herbert R Carroll, FNP
• Monica Jean Carroll, LVN
• Robert E Carroll, MD MPH
• Sydney E Carroll
• Charlene Carrow
• Christopher Carrow
• Andrea Mari Carruth, OTR

• Physician Assistant in San Antonio, TX
• Providers in San Antonio, TX by specialty
• Physician Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2023; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.