Alyssa Bene Carroll, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

085.008561 Issued in IL

Practice address

1001 Main St Ste 500a
Peoria, IL 61606-2038

Phone

(309) 672-4980

Fax

(309) 672-2931

NPI assigned

May 13, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: acarrollpa388414@carlehiedirect.net

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.

• Carle Health Care Incorporated

  dba Carle Physician Group

  • Internal Medicine Physician
  • Urbana, IL
  • NPI 1154653947
  Medicare reassignment NPD
• Methodist Medical Center of Illinois

  dba Methodist Medical Group

  • Family Medicine Physician
  • Peoria, IL
  • NPI 1184670663
  Medicare reassignment NPD
• Illinois Gastroenterology Group, LLC

  • Gastroenterology Physician
  • Elgin, IL
  • NPI 1316277817
  Medicare reassignment
• Methodist Medical Center of Illinois

  • Rehabilitation Hospital Unit
  • Peoria, IL
  • NPI 1982656575
  Medicare reassignment
• Elgin Gastroenterology Endoscopy Center LLC

  dba The Endo Center of Elgin Gastroenterology

  • Ambulatory Surgical Clinic/Center
  • Elgin, IL
  • NPI 1992875454
  NPD
• Elgin Gastroenterology SC

  • Gastroenterology Physician
  • Elgin, IL
  • NPI 1932291101
  NPD
• Methodist Medical Center of Illinois

  • General Acute Care Hospital
  • Peoria, IL
  • NPI 1164474755
  NPD
• Northwest Gastroenterologists SC

  • Specialist
  • Arlington Heights, IL
  • NPI 1801886221
  NPD

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

{
    "created_epoch": "1589328000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660694400000",
    "number": "1902428808",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 MAIN ST STE 500A",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616062038",
            "telephone_number": "309-672-4980",
            "fax_number": "309-672-2931"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 MAIN ST STE 500A",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616062038",
            "telephone_number": "309-672-4980",
            "fax_number": "309-672-2931"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARROLL",
        "first_name": "ALYSSA",
        "middle_name": "BENE",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-05-13",
        "last_updated": "2022-08-17",
        "certification_date": "2022-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085.008561",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Catherine L Carrara-O'Brien, MS, CCC-SLP/L
• Rachael Carrasca, PHARMD
• Cassidy Carrasco
• Lauren Carrasco
• Susan Carrasco
• Emily Carroll, MD
• Jennifer Carroll, CRNA
• John Carroll
• Carter Chiropractic Office LTD
• Ashleigh Carter

• Physician Assistant in Peoria, IL
• Providers in Peoria, IL by specialty
• Physician Assistant in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.