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DR. ROBERT MATTHEW CARROLL M.D.
NPI 1295875854
Internal Medicine - Hematology & Oncology in Newport Beach, CA

Active since February 06, 2007PECOS EnrolledAccepts Medicare Assignment
84.41/100
CMS Quality Rating
20162 SW BIRCH ST, SUITE 200, NEWPORT BEACH, CA 92660(949) 553-3330(949) 631-9012 Get Directions Write a Review

NPPES record last updated: May 13, 2010. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Dr. Robert Matthew Carroll M.d. NPPES

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

DR. ROBERT MATTHEW CARROLL M.D. (NPI 1295875854) is an individual hematology & oncology provider in Newport Beach, California, licensed in California (A69851) and active in the NPI registry since February 2007. He is enrolled in Medicare PECOS and is a graduate of Other (2001).

NPPES Registry Identity

NPI1295875854
Entity TypeIndividualMale
Primary Taxonomy207RH0003X
Provider Legal NameDR. ROBERT MATTHEW CARROLLCredential: M.D.
Location Address20162 SW BIRCH ST, SUITE 200Newport Beach, CA 92660-0787
Mailing Address20162 Sw Birch St, Suite 300Newport Beach, CA 92660-0787 · (949) 553-3330 · Fax (949) 631-9012
Phone(949) 553-3330
Fax(949) 631-9012
Sole ProprietorNo
Medical School CMSOtherGraduated 2001
Enumeration DateFebruary 6, 2007
Last NPPES UpdateMay 13, 2010
✔ NPI 1295875854 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · Hematology & OncologyAllopathic & Osteopathic Physicians
Taxonomy Code207RH0003X
License✔ Licensed in CA · A69851
Definition
An internist doctor of osteopathy that specializes in the treatment of the combination of hematology and oncology disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine WAS able to obtain a Certificate of Special Qualifications in the field of Hematology and Oncology. The Certificate is NO longer offered.
20162 SW BIRCH ST, Newport Beach, CA 92660
Open in Google Maps ↗

Other Identifiers 5

Medicare UPINI37037CA
Medicare UPIN137037CA
OtherAETNACA · 7861689
Other00A698510CA · Blueshield Of California
OtherWA69851ACA · Medicare Ppin

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Robert Matthew Carroll M.d. 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 ID8123058435
PECOS Enrollment IDI20101005000142
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.

Medicare Billing Reassignments

3

Medicare enrollment records show Robert Carroll reassigns Medicare billing to 3 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Uc Irvine Health Cancer Center, Newport Pacific Medical Center
3.1 mi
Infusion Therapy
1640 NEWPORT BLVD, SUITE 400
Costa Mesa, CA 92627
  • Reassigned Medicare billing, California enrollment
  • Medicare enrollment name: University Of California Irvine
  • 255 clinicians in this Medicare group
NPI 1558783696 (949) 999-2400
Hoag Clinic
3.7 mi
Primary Care
510 SUPERIOR AVE
Newport Beach, CA 92663
  • Reassigned Medicare billing, California enrollment
  • 529 clinicians in this Medicare group
NPI 1942799523 (949) 791-3001
Uc Regents
9.0 mi
Allergy & Immunology
101 THE CITY DR S
Orange, CA 92868
  • Reassigned Medicare billing, California enrollment
  • 525 clinicians in this Medicare group
NPI 1003864174 (714) 456-8068

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims 6

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Subsequent hospital care with straightforward or low level of medical decision making, per day, if using time, at least 25 minutes 99231
Follow-up hospital inpatient care is a daily service where a healthcare professional checks on your health progress during your hospital stay. Each session typically lasts 15 minutes, involving updates on your condition and adjustments to your treatment plan, if necessary.
111 services43 patients
Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes 99222
Initial hospital inpatient care is a service where a healthcare provider spends about 50 minutes per day overseeing your care while you're admitted in the hospital. This includes reviewing your health status, planning your treatment, and ensuring your safety and comfort.
106 services104 patients
Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes 99232
Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.
105 services55 patients
Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes 99233
Follow-up hospital inpatient care per day typically involves a 35-minute check-up by your healthcare provider. This service includes monitoring your health progress, adjusting your treatment plan if needed, and answering any questions you may have about your condition or care.
42 services29 patients
Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes 99223
Initial hospital inpatient care per day, typically 70 minutes, refers to the daily medical service provided to patients admitted to the hospital. This includes a comprehensive evaluation, diagnosis, treatment plan, and monitoring of your health condition. It ensures your well-being during your hospital stay.
22 services22 patients
Initial hospital care with straightforward or low level of medical decision making, per day, if using time, at least 40 minutes 99221
Initial hospital inpatient care refers to the first day of your stay in the hospital. This service typically includes a 30-minute check-up with a healthcare professional. They'll assess your health, discuss your condition, and plan your treatment. It's part of ensuring you receive the best possible care.
18 services18 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 92660 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$187.60 typical visit price
range $62.96 – $187.60
Typical copayment $46.90 (range $15.74 – $46.90)
Most-billed visit code 99205
Established Patient
$109.96 typical visit price
range $20.84 – $153.61
Typical copayment $27.49 (range $5.21 – $38.40)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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.

84.41/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality90.67
Promoting Interoperability100
Improvement Activities40
Cost57.36

Referred Medical Equipment & Supplies CMS DME claims 4

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Capecitabine, oral, 500 mg J8521
Treatment-Treatment - Miscellaneous · category RX029N
2 suppliers11 claims564 services$0.75 avg. paid by Medicare
Temozolomide, oral, 5 mg J8700
Treatment-Treatment - Miscellaneous · category RX000N
1 supplier14 claims1,485 services$0.41 avg. paid by Medicare
Pharmacy supply fee for oral anti-cancer, oral anti-emetic or immunosuppressive drug(s); for the first prescription in a 30-day period Q0511
Treatment-Chemotherapy · category RH012N
2 suppliers12 claims12 services$18.93 avg. paid by Medicare
Pharmacy supply fee for oral anti-cancer, oral anti-emetic or immunosuppressive drug(s); for a subsequent prescription in a 30-day period Q0512
Treatment-Chemotherapy · category RH012N
1 supplier13 claims21 services$12.63 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 8

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

NEIL M. BARTH, M.D., INC.
Internal Medicine (Hematology & Oncology)
20162 SW BIRCH ST, SUITE 200
NEWPORT BEACH, CA 92660
Orange County (949) 553-3330
DR. NEIL MICHAEL BARTH M.D.
Internal Medicine (Hematology & Oncology)
20162 SW BIRCH ST, SUITE 200
NEWPORT BEACH, CA 92660
Orange County (949) 553-3330
PREMIER DERMATOLOGY ASSOCIATES OF ORANGE COUNTY
Dermatology
20162 SW BIRCH ST, SUITE #250
NEWPORT BEACH, CA 92660
Orange County (949) 251-0427
KENNETH P. LYONS M.D.
Nuclear Medicine
20162 SW BIRCH ST, SUITE 150
NEWPORT BEACH, CA 92660
Orange County (949) 221-1700
HAY MEDICAL CORPORATION
Specialist
20162 SW BIRCH ST, SUITE 325
NEWPORT BEACH, CA 92660
Orange County (949) 955-1595
BIRCH RADIOLOGY ASSOCIATES, INC.
Radiology (Vascular & Interventional Radiology)
20162 SW BIRCH ST, SUITE 150
NEWPORT BEACH, CA 92660
Orange County (949) 221-1700
BIRCH MEDICAL OFFICE CENTER, LLC
Clinic/Center (Radiology)
20162 SW BIRCH ST, SUITE 150
NEWPORT BEACH, CA 92660
Orange County (949) 221-1700
ANNIE SCULLY BLANK
Marriage & Family Therapist
20162 SW BIRCH ST, 300
NEWPORT BEACH, CA 92660
Orange County (888) 717-9355

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Robert Carroll's NPI number?

The NPI number for Robert Carroll is 1295875854. It was assigned to this individual provider in the NPPES registry on February 6, 2007.

Where is Robert Carroll located?

Robert Carroll practices at 20162 SW Birch St Suite 200, Newport Beach, CA 92660. The listed phone number is (949) 553-3330.

What is Robert Carroll's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Hematology & Oncology, with taxonomy code 207RH0003X.

Is Robert Carroll enrolled in Medicare?

Yes. Robert Carroll is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organizations bill Medicare for Robert Carroll's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Robert Carroll reassigns Medicare benefits to 3 organizations: Uc Irvine Health Cancer Center, Newport Pacific Medical Center (Costa Mesa, CA), Hoag Clinic (Newport Beach, CA) and Uc Regents (Orange, CA). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Robert Carroll's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Robert Carroll was last updated on May 13, 2010. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.