Individual provider Active NPI

Patricia Joyce Carroll, PA

  • Surgical Physician Assistant
  • Colorado Springs, CO
National Provider Identifier
1992257950
Registry record updated Sep 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
0004750 Issued in CO
Practice address
4090 Briargate Pkwy
Colorado Springs, CO 80920-7815
Phone
(720) 777-1234
NPI assigned
Oct 25, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 5, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 0004750 CO
Surgical Physician Assistant 363AS0400X 0004750 CO Primary

Addresses

Primary practice location

4090 Briargate Pkwy
Colorado Springs, CO 80920-7815

Mailing address

PO Box 110429
Aurora, CO 80042-0429

Other practice location 1

1550 Pulsar Dr
Colorado Springs, CO 80916-4503
Phone (719) 574-7083

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
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
I20180906002395 CO Practitioner - Physician Assistant 4284984543 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0004750COMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Children's Hospital Colorado Current Accepting new patients
University Physicians Incorporated CurrentSince Sep 1, 2023 Accepting new patients
University Physicians, Incorporated CurrentSince Sep 1, 2023 Accepting new patients
University Physicians Incorporated Physician Assistant Past Accepting new patients

Locations

13123 E 16th Ave
Ste B130
Aurora, CO 80045

13123 E 16th Ave
Aurora, CO 80045
Phone (720) 777-3846

4090 Briargate Pkwy
Colorado Springs, CO 80920
Phone (719) 305-1234

Interoperability endpoints

  • Direct secure messaging: pcarroll274645@direct.childrenscolorado.org

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1477353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693872000000",
    "number": "1992257950",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 110429",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800420429"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4090 BRIARGATE PKWY",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809207815",
            "telephone_number": "720-777-1234"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1550 Pulsar Dr",
            "address_purpose": "LOCATION",
            "city": "Colorado Springs",
            "state": "CO",
            "postal_code": "809164503",
            "country_code": "US",
            "telephone_number": "719-574-7083",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CARROLL",
        "first_name": "PATRICIA",
        "middle_name": "JOYCE",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-10-25",
        "last_updated": "2023-09-05",
        "certification_date": "2023-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CO",
            "license": "0004750",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "CO",
            "license": "0004750",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Colorado Springs, CO

Sources for this page

Verify at the official NPI Registry.