Individual provider Active NPI

Carson Michelle Delgadillo

  • Physician Assistant
  • Moline, IL
National Provider Identifier
1730863549
Registry record updated Jul 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
600 John Deere Rd Ste 200
Moline, IL 61265-6897
Phone
(309) 779-4310
NPI assigned
Jun 12, 2023
Last updated
Jul 2, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 2, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary
Dermatology Physician 207N00000X 085.011309 IL
Dermatology Physician 207N00000X 085011309 IL

Addresses

Primary practice location

600 John Deere Rd Ste 200
Moline, IL 61265-6897

Mailing address

600 John Deere Rd Ste 200
Moline, IL 61265-6897
Phone (309) 779-4310

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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 1

Enrollment IDStateProvider typePAC IDDetails
I20250909002387 IL Practitioner - Physician Assistant 9436651288 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Medical Arts Associates, LTD.Group PAC ID 4385549377, 19 clinicians

Practice addresses (Care Compare)

600 John Deere Rd
Moline, IL 61265-6812
Phone (309) 779-4200

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
085.011309ILMDDermatology Physician

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.

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": "1686528000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751414400000",
    "number": "1730863549",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 JOHN DEERE RD STE 200",
            "city": "MOLINE",
            "state": "IL",
            "postal_code": "612656897",
            "telephone_number": "309-779-4310"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 JOHN DEERE RD STE 200",
            "city": "MOLINE",
            "state": "IL",
            "postal_code": "612656897",
            "telephone_number": "309-779-4310"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DELGADILLO",
        "first_name": "CARSON",
        "middle_name": "MICHELLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-06-12",
        "last_updated": "2025-07-02",
        "certification_date": "2025-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "IL",
            "license": "085.011309",
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "IL",
            "license": "085011309",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Moline, IL

Sources for this page

Verify at the official NPI Registry.