Active NPI
Todd A Carrell, MD
- Psychiatry Physician
- Vallejo, CA
National Provider Identifier
1932276227
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- A50250
- Practice address
- 532 Oregon St
Vallejo, CA 94590-3254 - Phone
- (707) 649-4007
- Fax
- (707) 649-4077
- NPI assigned
- Nov 29, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | A50250 | CA | Primary |
Addresses
Primary practice location
532 Oregon St
Vallejo, CA 94590-3254
Mailing address
532 Oregon St
Vallejo, CA 94590-3254
Phone (707) 649-4007
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00A502500 | Medicaid | CA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20120524000448 | CA | Practitioner - Psychiatry | 2365605672 | Practice locations: Vallejo, CA |
Care Compare profile
Medicare Care Compare- Specialty
- Psychiatry
- Education
- Baylor College of Medicine, 1988
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
Practice addresses (Care Compare)
532 Oregon St
Vallejo, CA 94590-3254
Phone (707) 649-4007
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A50250 | CA | MD | Psychiatry Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1164758400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1932276227",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "532 OREGON ST",
"city": "VALLEJO",
"state": "CA",
"postal_code": "945903254",
"telephone_number": "707-649-4007",
"fax_number": "707-649-4077"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "532 OREGON ST",
"city": "VALLEJO",
"state": "CA",
"postal_code": "945903254",
"telephone_number": "707-649-4007",
"fax_number": "707-649-4077"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CARRELL",
"first_name": "TODD",
"middle_name": "A",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-11-29",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "CA",
"license": "A50250",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00A502500",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Vallejo, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.