Nicole Carrillo

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

R4460 Issued in TX

Practice address

1500 S Main St
Fort Worth, TX 76104-4917

Phone

(817) 702-3431

NPI assigned

Mar 30, 2015

Last updated

Mar 6, 2025By the provider in NPPES

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 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

Emergency Medicine

Education

Arizona College of Osteopathic Medicine Mid Western University, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Century Integrated Partners, IncGroup PAC ID 6406151703, 330 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Baylor Scott & White Medical Center- Waxahachie Hospital, Waxahachie, TX, CCN 450372
• Texas Health Huguley Hospital Fort Worth South Hospital, Fort Worth, TX, CCN 450677

Merit-based Incentive Payment System (MIPS)

Final score

99.43 of 100Reported as group

Quality

93.73

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Century Integrated Partners, Inc

  • Emergency Medicine Physician
  • Dallas, TX
  • NPI 1447615711
  Medicare reassignment Care Compare group NPD
• Huguley Emergency Physicians, LLP

  • Emergency Medical Services (Emergency Medicine) Physician
  • Fort Worth, TX
  • NPI 1346265071
  Medicare reassignment NPD
• Integrative Emergency Services Physician Group PA

  • Emergency Medicine Physician
  • Fort Worth, TX
  • NPI 1285922542
  Medicare reassignment NPD
• Integrative Emergency Services Physician Group-Houston PLLC

  dba IES Houston

  • Emergency Medicine Physician
  • Pasadena, TX
  • NPI 1801458708
  Medicare reassignment NPD
• St. Luke's Community Health Services

  • Rehabilitation Hospital Unit
  • The Woodlands, TX
  • NPI 1255785382
  NPD (past)

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

• Baylor Medical Center at Waxahachie

  dba Baylor Scott & White Medical Center - Waxahachie

  • General Acute Care Hospital
  • Waxahachie, TX
  • NPI 1265430177
  Care Compare affiliation
• Texas Health Huguley, Inc

  dba Texas Health Huguley Hospital Fort Worth South

  • Psychiatric Hospital Unit
  • Burleson, TX
  • NPI 1518355759
  Care Compare affiliation
• Texas Health Huguley, Inc.

  dba Texas Health Huguley Hospital Fort Worth South

  • General Acute Care Hospital
  • Burleson, TX
  • NPI 1033120423
  Care Compare affiliation
• Texas Health Huguley, Inc.

  dba Huguley Memorial Medical Center

  • Psychiatric Hospital Unit
  • Burleson, TX
  • NPI 1548273881
  Care Compare affiliation

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

{
    "created_epoch": "1427673600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741219200000",
    "number": "1942695796",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 S MAIN ST",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761044917",
            "telephone_number": "817-702-3431"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 S MAIN ST",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761044917",
            "telephone_number": "817-702-3431"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARRILLO",
        "first_name": "NICOLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-03-30",
        "last_updated": "2025-03-06",
        "certification_date": "2025-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TX",
            "license": "R4460",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brenna Brianne Carrillo-Zazueta, DDS
• Cora Anne Carrillo, OTR, OTD
• Edith Cristina Carrillo
• Mark Cole Carrillo, CRNA
• Miguel Carrillo
• Pamela Rose Carrington-Pratt, CRNA
• Frederick Carrington, MD
• Bryan J Carroll, M.D.
• Chiyon Carroll
• Irene V Carroll, O.T.

• Emergency Medicine Physician in Fort Worth, TX
• Providers in Fort Worth, TX by specialty
• Emergency Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2025; 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.