John Carroll, MD is a medicare enrolled "Emergency Medicine" physician in West Peoria, Illinois. His current practice location is
2727 W Heading Ave, West Peoria, Illinois. You can reach out to his office (for appointments etc.) via phone at
(309) 648-1087.
John Carroll is licensed to practice in Illinois (license number 036.064215) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1376852301.
Physician's Profile
Full Name | John Carroll |
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Gender | Male |
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Speciality | Emergency Medicine |
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Location | 2727 W Heading Ave, West Peoria, Illinois |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1376852301
- Provider Enumeration Date: 09/24/2010
- Last Update Date: 09/24/2010
Medicare PECOS Information:
- PECOS PAC ID: 3971918707
- Enrollment ID: I20210209000895
Medical Identifiers
Medical identifiers for John Carroll such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1376852301 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
207P00000X | Emergency Medicine | 036.064215 (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. John Carroll allows following entities to bill medicare on his behalf.
Entity Name | Dhhs Phs Naihs Shiprock Hospital |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1780639971 PECOS PAC ID: 0749193837 Enrollment ID: O20031105000809 |
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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. John 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 |
John Carroll, MD 2727 W Heading Ave, West Peoria, IL 61604-4981 Ph: (309) 648-1087 | John Carroll, MD 2727 W Heading Ave, West Peoria, IL 61604-4981 Ph: (309) 648-1087 |
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