Edward Michael McCarthy, MD

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

L5831 Issued in TX

Practice address

4512 Van Winkle Dr
Amarillo, TX 79119

Phone

(806) 358-1497

Fax

(806) 358-1375

NPI assigned

Jul 5, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Dermatology

Education

University of Texas Medical Branch at Galveston, 1999

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Amarillo Dermatology, P.a.Group PAC ID 0749324838, 2 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

0 of 100Reported as individual

Quality

0

Improvement activities

0

Cost

0

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Amarillo Dermatology, P.a.

  • Dermatology Physician
  • Amarillo, TX
  • NPI 1619976685
  Medicare reassignment Care Compare group NPD Authorized official

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

{
    "created_epoch": "1120521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631577600000",
    "number": "1902803976",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4512 VAN WINKLE DR",
            "city": "AMARILLO",
            "state": "TX",
            "postal_code": "79119",
            "telephone_number": "806-358-1497",
            "fax_number": "806-358-1375"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4512 VAN WINKLE DR",
            "city": "AMARILLO",
            "state": "TX",
            "postal_code": "79119",
            "telephone_number": "806-358-1497",
            "fax_number": "806-358-1375"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCARTHY",
        "first_name": "EDWARD",
        "middle_name": "MICHAEL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-05",
        "last_updated": "2021-09-14",
        "certification_date": "2021-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "TX",
            "license": "L5831",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "157344601",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "157343801",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE NUMBER",
            "identifier": "P00005113",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Aldeena Marie McAlister
• Angela T McBroom, PA-C
• Kenneth L McCall III, PHARM.D.
• Nancy McCallick, OT
• Jamie Lee McCarrell, PHARM.D.
• Rebecca A. McCarthy, MD
• Michael McCartor, D.M.D
• Amanda McCarty, CPM, LM
• Christopher Alan McCarty, M.D.
• Ilean Pamela McCarty

• Dermatology Physician in Amarillo, TX
• Providers in Amarillo, TX by specialty
• Dermatology Physician in Texas

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

Verify at the official NPI Registry.