Brendan Thomas More Carroll, M.D.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

35-061694 Issued in OH

Practice address

188 W Hebble Ave
Fairborn, OH 45324-4960

Phone

(614) 893-0910

Fax

(614) 879-4169

NPI assigned

Aug 31, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Enrolled in OH

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 1

Specialty

Psychiatry

Education

University of Toledo College of Medicine, 1987

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Adena Medical Group LLCGroup PAC ID 1153456579, 384 clinicians

North Community Counseling Centers, IncGroup PAC ID 5698721751, 8 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Adena Regional Medical Center Hospital, Chillicothe, OH, CCN 360159

Merit-based Incentive Payment System (MIPS)

Final score

82.93 of 100Reported as group

Quality

64.42

Promoting interoperability

99

Improvement activities

40

Cost

73.2

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.qualifacts.org/api/fhir/pathihc/r4/
• FHIR API: https://api.qualifacts.org/api/fhir/northcommunity/r4/
• Direct secure messaging: bcarroll1086676@direct.osumc.edu

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.

• Adena Medical Group LLC

  • Family Medicine Physician
  • Chillicothe, OH
  • NPI 1235468083

  OH, Psychiatry

  Medicare reassignment Care Compare group NPD
• North Community Counseling Centers Inc

  • Clinic/Center
  • Columbus, OH
  • NPI 1003085648

  OH

  Medicare reassignment Care Compare group NPD
• Phoenix Group Home, LLC

  • Community/Behavioral Health Agency
  • Portsmouth, OH
  • NPI 1083146013

  OH

  Medicare reassignment NPD
• Premier Health Specialists Inc

  • Internal Medicine Physician
  • Moraine, OH
  • NPI 1194958223

  OH

  Medicare reassignment NPD
• Third Street Community Clinic Inc

  • Federally Qualified Health Center (FQHC)
  • Marion, OH
  • NPI 1861170565

  OH

  Medicare reassignment NPD
• Phoenix Group Home, LLC

  • Substance Abuse Rehabilitation Facility
  • Cincinnati, OH
  • NPI 1336654854
  NPD
• Premier Health Specialists Inc

  • Foot & Ankle Surgery Podiatrist
  • Dayton, OH
  • NPI 1902211287
  NPD
• Third Street Community Clinic, Inc

  • Community/Retail Pharmacy
  • Mansfield, OH
  • NPI 1497485973
  NPD
• Adena Health System

  • General Acute Care Hospital
  • Chillicothe, OH
  • NPI 1902839673
  NPD (past)
• Eastern Idaho Health Services Inc

  • General Acute Care Hospital
  • Idaho Falls, ID
  • NPI 1225082209
  NPD (past)
• Eastern Idaho Health Services Inc

  • Psychiatric Hospital Unit
  • Idaho Falls, ID
  • NPI 1740287911
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Adena Health System

  • General Acute Care Hospital
  • Chillicothe, OH
  • NPI 1902839673

  Hospital

  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655251200000",
    "number": "1861503591",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "330 TAYLOR BLAIR RD",
            "address_2": "THE NEUROSCIENCE ALLIANCE, LLC",
            "city": "WEST JEFFERSON",
            "state": "OH",
            "postal_code": "431629714",
            "telephone_number": "614-893-0910"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "188 W HEBBLE AVE",
            "city": "FAIRBORN",
            "state": "OH",
            "postal_code": "453244960",
            "telephone_number": "614-893-0910",
            "fax_number": "614-879-4169"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARROLL",
        "first_name": "BRENDAN",
        "middle_name": "THOMAS MORE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-31",
        "last_updated": "2022-06-15",
        "certification_date": "2022-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084F0202X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Forensic Psychiatry",
            "state": "OH",
            "license": "61694",
            "primary": false
        },
        {
            "code": "2084F0202X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Forensic Psychiatry",
            "state": "OH",
            "license": "35-061694",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "OH",
            "license": "61694",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "OH",
            "license": "35-061694",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Adrian Canty
• Sally Caraballo, D.P.M.
• Seneca Marie Cardiff, DO
• Caring Solutions NP LLC
• Shelbi Carpenter
• Michael A Carter, CDC-A
• Timothy Carter III
• Anthony Casillano
• Coleen Phillips Casillano
• Samantha Casteel

• All providers in Fairborn, OH
• Psychiatry Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2022; 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.

Verify at the official NPI Registry.