Individual provider Active NPI

Thomas Carroll, D.O.

  • Anesthesiology Physician
  • Sioux City, IA
National Provider Identifier
1861750853
Registry record updated Dec 30, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
R-09509 Issued in IA
Practice address
2720 Stone Park Blvd
Sioux City, IA 51104-3734
Phone
(712) 279-3209
NPI assigned
Apr 26, 2012
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 30, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 65424-21 WI
Student in an Organized Health Care Education/Training Program 390200000X
Anesthesiology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207L00000X R-09509 IA Primary

Addresses

Primary practice location

2720 Stone Park Blvd
Sioux City, IA 51104-3734

Mailing address

3629 Lindenwood St
Sioux City, IA 51104-2255
Phone (651) 245-6304

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
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

Enrollment IDStateProvider typePAC IDDetails
I20201020000417 IA Practitioner - AnesthesiologyPractitioner - Interventional Pain ManagementPractitioner - Pain Management 1850532607 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
AnesthesiologyAlso: Interventional Pain Management, Pain Management
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Anesthesia Consultants PCGroup PAC ID 6103716626, 20 clinicians

Practice addresses (Care Compare)

2720 Stone Park Blvd
Sioux City, IA 51104-3734
Phone (712) 259-3000

Hospital & facility affiliations

  • St Lukes Regional Medical Center Hospital, Sioux City, IA, CCN 160146

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R-09509IAMDAnesthesiology Physician
65424-21WIMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Anesthesia Consultants PC Single Specialty CurrentSince Nov 1, 2020 Accepting new patients
St Luke'S Methodist Hospital Current Accepting new patients
Eau Claire Anesthesiologists LTD Single Specialty Past Accepting new patients

Locations

2730 Pierce St
Sioux City, IA 51104
Phone (712) 224-3380

2720 Stone Park Blvd
Sioux City, IA 51104
Phone (712) 259-3000

2730 Pierce St
Ste 100
Sioux City, IA 51104
Phone (712) 294-7693

Interoperability endpoints

  • Direct secure messaging: tcarroll259139@direct.unitypoint.org

Organizations & group practices 3

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.

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": "1335398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640822400000",
    "number": "1861750853",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3629 LINDENWOOD ST",
            "city": "SIOUX CITY",
            "state": "IA",
            "postal_code": "511042255",
            "telephone_number": "651-245-6304"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2720 STONE PARK BLVD",
            "city": "SIOUX CITY",
            "state": "IA",
            "postal_code": "511043734",
            "telephone_number": "712-279-3209"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARROLL",
        "first_name": "THOMAS",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-04-26",
        "last_updated": "2021-12-30",
        "certification_date": "2021-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "WI",
            "license": "65424-21",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Anesthesiology",
            "state": "IA",
            "license": "R-09509",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sioux City, IA

Sources for this page

Verify at the official NPI Registry.