Individual provider Active NPI

Carlton Dicarlo, PA

  • Physician Assistant
  • Palatka, FL
National Provider Identifier
1962473389
Registry record updated Feb 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA2025 Issued in FL
Practice address
1302 River St
Palatka, FL 32177-5042
Phone
(386) 328-8371
Fax
(386) 325-1086
NPI assigned
Feb 1, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 18, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA2025 FL Primary

Addresses

Primary practice location

1302 River St
Palatka, FL 32177-5042

Mailing address

1302 River St
Palatka, FL 32177-5042
Phone (386) 328-8371

Other identifiers 1

IdentifierTypeStateIssuer
290235400MedicaidFL

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20250714002703 FL Practitioner - Physician Assistant 5991093403 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Rural Health Care IncorporatedGroup PAC ID 7214849520, 29 clinicians

Practice addresses (Care Compare)

1302 River St
Palatka, FL 32177-5042
Phone (386) 328-8371

Hospital & facility affiliations

  • HCA Florida Putnam Hospital Hospital, Palatka, FL, CCN 100232

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Rural Health Care, Inc. CurrentSince Dec 2, 2024 Accepting new patients
Rural Health Care Incorporated CurrentSince Dec 2, 2024 Accepting new patients
Rural Health Care Incorporated Past Accepting new patients

Locations

1302 River St
Palatka, FL 32177
Phone (386) 328-0108

Interoperability endpoints

  • Direct secure messaging: carlton.dicarlo.p1@direct.azahealth.nextgenshare.com

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": "1138752000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739836800000",
    "number": "1962473389",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1302 RIVER ST",
            "city": "PALATKA",
            "state": "FL",
            "postal_code": "321775042",
            "telephone_number": "386-328-8371",
            "fax_number": "386-325-1086"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1302 RIVER ST",
            "city": "PALATKA",
            "state": "FL",
            "postal_code": "321775042",
            "telephone_number": "386-328-8371",
            "fax_number": "386-325-1086"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DICARLO",
        "first_name": "CARLTON",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-02-01",
        "last_updated": "2025-02-18",
        "certification_date": "2025-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA2025",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "290235400",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Palatka, FL

Sources for this page

Verify at the official NPI Registry.