Active NPI
Brian Keith Carreon, M.D.
- Family Medicine Physician
- Shallowater, TX
National Provider Identifier
1831162221
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- L9125
- Practice address
- 1502 12TH St
Suite a
Shallowater, TX 79363-5652 - Phone
- (806) 832-4566
- Fax
- (806) 832-4143
- NPI assigned
- Feb 8, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | L9125 | TX | Primary |
| Emergency Medicine Physician | 207P00000X | L9125 | TX |
Addresses
Primary practice location
1502 12TH St
Suite a
Shallowater, TX 79363-5652
Mailing address
PO Box 2088
Shallowater, TX 79363-2088
Phone (806) 832-4566
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 168484709 | Medicaid | TX | |
| 168484708 | Medicaid | TX |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | Brian.Carreon@direct.myteamcare.com |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20041026001127 | TX | Practitioner - Family Practice | 1658332234 | Reassigns benefits to 2 organizations |
Care Compare profile
Medicare Care Compare- Specialty
- Family Practice
- Education
- Texas Tech University Health Science Center School of Medicine, 2003
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1502 12TH St
Suite a
Shallowater, TX 79363-5651
Phone (806) 696-3700
Hospital & facility affiliations
- Calvert Home Health Care, LLC
- Enhabit Home Health
- University Medical Center
- Lamb Healthcare Center
- Grace Surgical Hospital
- Covenant Childrens Hospital
- Fisher County Hospital District
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Removal of skin lesions | 1-10 |
| Removal of nail tissue | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| L9125 | TX | MD | Emergency Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Concord Medical Group PLLC | Emergency Medicine | Current | Accepting new patients |
| Concord Medical Group of Texas PLLC | Emergency Medicine | Current | Accepting new patients |
| Brian Carreon MD PA | Family Medicine | Current | Accepting new patients |
| Seminole Hospital District of Gaines County Texas | Emergency Medicine | Past | Accepting new patients |
| Fisher County Hospital District | Past | Accepting new patients | |
| Southwest Medical Associates, Inc. | Emergency Medicine | Past | Accepting new patients |
| Seminole Hospital District of Gaines County Texas | Past | Accepting new patients |
Locations
101 Avenue J
Anson, TX 79501
Phone (325) 823-3231
1416 George Dieter Dr
El Paso, TX 79936
Phone (877) 822-6281
1 Avenue N
Haskell, TX 79521
Phone (940) 228-4321
310 W South St
Henrietta, TX 76365
Phone (806) 647-2191
1500 S Sunset Ave
Littlefield, TX 79339
Phone (806) 385-6411
1502 12th St
Ste A
Shallowater, TX 79363
Phone (806) 392-5935
305 N McKinney St
Sweeny, TX 77480
Phone (979) 548-1500
Interoperability endpoints
- sycamorefamilymedicine.briancarreon@147886.advancedmd-direct.com
Organizations & group practices 7
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Emergency Medicine Physician
- Lubbock, TX
- NPI 1083630610
Emergency Medicine, TX
-
- Emergency Medicine Physician
- Lubbock, TX
- NPI 1750790762
Emergency Medicine
-
- Rural Health Clinic/Center
- Rotan, TX
- NPI 1104808112
-
- Rural Health Clinic/Center
- Seminole, TX
- NPI 1467879569
-
- Critical Access Hospital
- Seminole, TX
- NPI 1821025990
Emergency Medicine
-
- Emergency Medicine Physician
- Electra, TX
- NPI 1831299122
Emergency Medicine
Hospital & facility affiliations 11
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Home Health Agency
- Lubbock, TX
- NPI 1679870463
-
- Home Health Agency
- Lubbock, TX
- NPI 1801866306
-
- Ambulatory Surgical Clinic/Center
- Lubbock, TX
- NPI 1538245717
Hospital
-
- Hearing and Speech Clinic/Center
- Lubbock, TX
- NPI 1831299114
Hospital
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1139356800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1610582400000",
"number": "1831162221",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 2088",
"city": "SHALLOWATER",
"state": "TX",
"postal_code": "793632088",
"telephone_number": "806-832-4566",
"fax_number": "806-832-4143"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1502 12TH ST",
"address_2": "SUITE A",
"city": "SHALLOWATER",
"state": "TX",
"postal_code": "793635652",
"telephone_number": "806-832-4566",
"fax_number": "806-832-4143"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CARREON",
"first_name": "BRIAN",
"middle_name": "KEITH",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-02-08",
"last_updated": "2021-01-14",
"certification_date": "2021-01-14",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "TX",
"license": "L9125",
"primary": true
},
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "TX",
"license": "L9125",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "168484709",
"state": "TX"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "168484708",
"state": "TX"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "Brian.Carreon@direct.myteamcare.com",
"affiliation": "N",
"address_1": "1502 12th St",
"address_2": "Suite A",
"city": "Shallowater",
"state": "TX",
"country_code": "US",
"postal_code": "793635652",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Shallowater, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2021; 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.
- 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.