Individual provider Active NPI

Carle E Rollins, DPM

  • Podiatrist
  • Wilmette, IL
National Provider Identifier
1790872786
Registry record updated Aug 12, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
016002846 Issued in IL
Practice address
1919 Lake Ave a
Wilmette, IL 60091-1422
Phone
(847) 256-3338
Fax
(847) 256-4437
NPI assigned
Oct 9, 2006
Last updated
Aug 12, 2016By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 12, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X 016002846 IL Primary

Addresses

Primary practice location

1919 Lake Ave a
Wilmette, IL 60091-1422

Mailing address

1919 Lake Ave, Suite a
Wilmette, IL 60091-1422
Phone (847) 256-4434

Other identifiers 2

IdentifierTypeStateIssuer
60020930OtherILBLUE CROSS BLUE SHIELD
016002846MedicaidIL

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040816000765 IL Practitioner - Podiatry 5799758017 Practice locations: Evanston, IL; Deerfield, IL; Wilmette, IL; Wheeling, IL; Highland Park, IL; Lincolnwood, IL

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
William M. Scholl College of Podiatric Medicine, 1975
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

820 Foster St
Evanston, IL 60201-3212
Phone (847) 492-7700

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of nail tissue184
Removal or shaving of skin growth64

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Gary J Rogers DPM PC Podiatrist PastSince Feb 1, 1999 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": "1160352000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1470960000000",
    "number": "1790872786",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1919 LAKE AVE, SUITE A",
            "city": "WILMETTE",
            "state": "IL",
            "postal_code": "600911422",
            "telephone_number": "847-256-4434",
            "fax_number": "847-256-4437"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1919 LAKE AVE A",
            "city": "WILMETTE",
            "state": "IL",
            "postal_code": "600911422",
            "telephone_number": "847-256-3338",
            "fax_number": "847-256-4437"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROLLINS",
        "first_name": "CARLE",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-09",
        "last_updated": "2016-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "IL",
            "license": "016002846",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "60020930",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "016002846",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilmette, IL

Sources for this page

Verify at the official NPI Registry.