EDWARD JAMES CARROLL PA-C
NPI 1083676779
Physician Assistant - Surgical in Lakeland, FL

Q: What is Edward Carroll's NPI number?

The NPI number for Edward Carroll is 1083676779. It was assigned to this individual provider in the NPPES registry on April 6, 2006.

Q: What is Edward Carroll's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Surgical, with taxonomy code 363AS0400X.

Q: When was this NPI record last updated?

The NPPES record for Edward Carroll was last updated on May 1, 2023. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since April 06, 2006PECOS EnrolledAccepts Medicare Assignment

80.11/100

CMS Quality Rating

1324 LAKELAND HILLS BLVD, LAKELAND, FL 33805(863) 687-1321(863) 284-1730 Get Directions Write a Review

NPPES record last updated: May 1, 2023. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: May 1, 2023, Jul 10, 2017, Jul 7, 2017 (3 updates tracked since 2017).

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About Edward James Carroll Pa-c NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

EDWARD JAMES CARROLL PA-C (NPI 1083676779) is an individual surgical provider in Lakeland, Florida, licensed in Florida (PA9101893) and active in the NPI registry since April 2006. He is enrolled in Medicare PECOS, is affiliated with Lakeland Regional Medical Center, and is a graduate of Other (2000).

NPPES Registry Identity

NPI1083676779

Entity TypeIndividualMale

Primary Taxonomy363AS0400X

Provider Legal NameEDWARD JAMES CARROLLCredential: PA-C

Location Address1324 LAKELAND HILLS BLVDLakeland, FL 33805-4543

Mailing Address1324 Lakeland Hills Blvd., Attn: Managed Care Dept.Lakeland, FL 33805

Phone(863) 687-1321

Fax(863) 284-1730

Sole ProprietorNo

Medical School CMSOtherGraduated 2000

Enumeration DateApril 6, 2006

Last NPPES UpdateMay 1, 20233 updates tracked since enumeration

NPPES CertifiedMay 1, 2023

✔ NPI 1083676779 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPhysician Assistant · SurgicalPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363AS0400X

License✔ Licensed in FL · PA9101893

Also ListedPhysician AssistantTaxonomy 363A00000X

1324 LAKELAND HILLS BLVD, Lakeland, FL 33805

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Other Identifiers 1

Medicaid291529400FL

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include AvMed.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Edward James Carroll Pa-c is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID9133395064

PECOS Enrollment IDI20111227000453

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Lakeland Regional Medical Center

Acute Care Hospitals · Lakeland, FL

1/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number100157

Location1324 Lakeland Hills BlvdLakeland, FL 33805 · Polk County

Emergency services Birthing friendly

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

80.11/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Scored as part of a group practice

Quality

63.29

Promoting Interoperability

Improvement Activities

Cost

64.85

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

RAMIZ GUNDKALLI MD

Anesthesiology