Individual provider Active NPI

Michael J Carl, MD

  • Physical Medicine & Rehabilitation Physician
  • Kokomo, IN
National Provider Identifier
1700858057
Registry record updated Nov 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
01087520A Issued in IN
Practice address
107 S Washington St Ste C
Kokomo, IN 46901-4601
Phone
(765) 450-6735
NPI assigned
Feb 2, 2006
Last updated
Nov 27, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 27, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X 01087520A IN Primary
Physical Medicine & Rehabilitation Physician 208100000X 19307 OK

Addresses

Primary practice location

107 S Washington St Ste C
Kokomo, IN 46901-4601

Mailing address

PO Box 5748
Lafayette, IN 47903-5748
Phone (765) 714-4344

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220624001564 IN Practitioner - Interventional Pain ManagementPractitioner - Pain ManagementPractitioner - Physical Medicine and Rehabilitation 7719985910 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
68.67 of 100Reported as individual
Quality
90
Improvement activities
0
Cost
81.79

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
01087520AINMDPhysical Medicine & Rehabilitation Physician
19307OKMDPhysical Medicine & Rehabilitation Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lafayette Pain Care, P.C. CurrentSince Jul 31, 2022 Accepting new patients
Lafayette Pain Care PC CurrentSince Jul 31, 2022 Accepting new patients
Coastal Orthopedics & Sports Medicine,P.a. Past Accepting new patients

Locations

107 S Washington St
Ste C
Kokomo, IN 46901
Phone (317) 798-0040

770 Park East Blvd
Ste B
Lafayette, IN 47905
Phone (765) 366-4344

707 N River Dr
Marion, IN 46952
Phone (765) 573-5999

613 Terrace Dr
Winamac, IN 46996
Phone (574) 946-4290

Interoperability endpoints

  • Direct secure messaging: mcarl66146@direct.thedacare.org

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, 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": "1138838400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701043200000",
    "number": "1700858057",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5748",
            "city": "LAFAYETTE",
            "state": "IN",
            "postal_code": "479035748",
            "telephone_number": "765-714-4344",
            "fax_number": "405-735-9934"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 S WASHINGTON ST STE C",
            "city": "KOKOMO",
            "state": "IN",
            "postal_code": "469014601",
            "telephone_number": "765-450-6735"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARL",
        "first_name": "MICHAEL",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-02",
        "last_updated": "2023-11-27",
        "certification_date": "2023-11-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "IN",
            "license": "01087520A",
            "primary": true
        },
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "OK",
            "license": "19307",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kokomo, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.