Individual provider Active NPI

Jason Miller Dicarlo, MD

  • Diagnostic Radiology Physician
  • Augusta, GA
National Provider Identifier
1831301985
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
RTP001865 Issued in GA
Practice address
1120 15TH St
Augusta, GA 30912-0004
Phone
(706) 721-3214
NPI assigned
May 3, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X RTP001865 GA Primary

Addresses

Primary practice location

1120 15TH St
Augusta, GA 30912-0004

Mailing address

4117 Mansfield PL
Martinez, GA 30907-2677
Phone (757) 235-3866

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO, TX, NV, LA4 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 4

Enrollment IDStateProvider typePAC IDDetails
I20121023000689 CO Practitioner - Diagnostic Radiology 3577689314 Reassigns benefits to 2 organizations
I20210106000111 TX Practitioner - Diagnostic Radiology 3577689314 Reassigns benefits to 1 organization
I20240604002505 NV Practitioner - Diagnostic Radiology 3577689314 Reassigns benefits to 1 organization
I20260427001379 LA Practitioner - Diagnostic Radiology 3577689314 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Other, 2005
Medicare assignment
May accept Medicare assignment
Group practices
Radiology Specialists LTD Marasso-MillerGroup PAC ID 0143110874, 136 clinicians

Practice addresses (Care Compare)

7130 Smoke Ranch Rd
Suite 101
Las Vegas, NV 89128-3157
Phone (866) 722-1655

96 Zinnia Dr
Covington, LA 70433-9116
Phone (866) 722-1655

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
24318NVMDPharmacist
RTP001865GAMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mountain Radiology, Inc Diagnostic Radiology CurrentSince Sep 1, 2012 Accepting new patients
Radiology Imaging Corpus Christi, PLLC Diagnostic Radiology CurrentSince May 1, 2022 Accepting new patients
Radiology Specialists LTD Marasso-Miller Diagnostic Radiology CurrentSince Apr 21, 2024 Accepting new patients
Swedish Radia Imaging Center at Edmonds LLC Diagnostic Radiology Past Accepting new patients
Evergreen Radia LLC Diagnostic Radiology Past Accepting new patients
Radia Inc P S Diagnostic Radiology Past Accepting new patients
Radiology Associates of Hartford PLLC Diagnostic Radiology Past Accepting new patients

Locations

401 Castle Creek Rd
Aspen, CO 81611
Phone (970) 544-1192

1460 E Valley Rd
Ste 102
Basalt, CO 81621
Phone (970) 544-1260

234 E Cody Ln
Basalt, CO 81621
Phone (970) 544-1250

377 Sylvan Lake Rd
Eagle, CO 81631
Phone (970) 328-1650

1906 Blake Ave
Glenwood Springs, CO 81601
Phone (970) 384-7033

504 21st St
Glenwood Springs, CO 81601
Phone (970) 384-7640

2635 N 7th St
Grand Junction, CO 81501
Phone (970) 244-2009

100 Pmc Dr
Meeker, CO 81641
Phone (970) 878-4014

201 Sipprelle Dr
Parachute, CO 81635
Phone (970) 285-5731

501 Airport Rd
Rifle, CO 81650
Phone (970) 625-1100

2001 N Horseshoe Trl
Silt, CO 81652
Phone (970) 876-5700

410 Benedicta Ave
Trinidad, CO 81082
Phone (719) 846-8051

4241 Vets Blvd
Ste 200
Metairie, LA 70006

3100 N Tenaya Way
Las Vegas, NV 89128
Phone (702) 225-5025

3186 S Maryland Pkwy
Las Vegas, NV 89109
Phone (702) 731-8000

7130 Smoke Ranch Rd
Ste 101
Las Vegas, NV 89128
Phone (702) 304-8135

2825 Spohn Dr S
Corpus Christi, TX 78414
Phone (361) 991-9595

3226 S Alameda St
Corpus Christi, TX 78404
Phone (361) 888-6684

Organizations & group practices 9

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 2

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": "1178150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1831301985",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4117 MANSFIELD PL",
            "city": "MARTINEZ",
            "state": "GA",
            "postal_code": "309072677",
            "telephone_number": "757-235-3866"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1120 15TH ST",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309120004",
            "telephone_number": "706-721-3214"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DICARLO",
        "first_name": "JASON",
        "middle_name": "MILLER",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "GA",
            "license": "RTP001865",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Augusta, GA

Sources for this page

Verify at the official NPI Registry.