Elaine Marie Carroll, MD is a medicare enrolled "Obstetrics & Gynecology" physician in Pontiac, Illinois. Her current practice location is
1508 W Reynolds St, Pontiac, Illinois. You can reach out to her office (for appointments etc.) via phone at
(815) 844-4611.
Elaine Marie Carroll is licensed to practice in Illinois (license number 36085505) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1598739492.
Physician's Profile
| Full Name | Elaine Marie Carroll |
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| Gender | Female |
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| Speciality | Obstetrics & Gynecology |
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| Location | 1508 W Reynolds St, Pontiac, Illinois |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1598739492
- Provider Enumeration Date: 02/15/2006
- Last Update Date: 04/20/2022
Medicare PECOS Information:
- PECOS PAC ID: 8527094937
- Enrollment ID: I20050715000915
Medical Identifiers
Medical identifiers for Elaine Marie Carroll such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1598739492 | NPI | - | NPPES |
| 206147 | Other | IL | MEDICARE PTAN (GROUP) |
| 036085505 | Medicaid | IL | |
| 206147098 | Other | IL | MEDICARE PTAN (INDIVIDUAL) |
| 181980007 | Other | IN | MEDICARE PTAN |
| 200265610 | Medicaid | IN | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 207VM0101X | Obstetrics & Gynecology - Maternal & Fetal Medicine | 01076901A (Indiana) | Secondary |
| 207VM0101X | Obstetrics & Gynecology - Maternal & Fetal Medicine | 036085505 (Illinois) | Secondary |
| 207V00000X | Obstetrics & Gynecology | 36085505 (Illinois) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Elaine Marie Carroll allows following entities to bill medicare on her behalf.
| Entity Name | Richland Memorial Hospital Inc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1467492124
PECOS PAC ID: 3870565732
Enrollment ID: O20040811000131 |
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| Entity Name | Carle West Physician Group Inc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1467074138
PECOS PAC ID: 8921420308
Enrollment ID: O20200613000147 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Elaine Marie Carroll is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
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Elaine Marie Carroll, MD
611 W Park St,
Urbana, IL 61801-2529
Ph: () - | Elaine Marie Carroll, MD
1508 W Reynolds St,
Pontiac, IL 61764-2811
Ph: (815) 844-4611 |
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