1. Home
  2. Directory
  3. Georgia
  4. Gainesville
  5. General Practice
  6. NPI Profile

RODOLFO BARTOLOME CARRILLO SR. MD
NPI 1376633586
General Practice in Gainesville, GA

Active since October 16, 2006PECOS Enrolled
420 BROAD ST SE, GAINESVILLE, GA 30501(770) 536-8885(770) 536-8725 Get Directions Write a Review

NPPES record last updated: July 8, 2007. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Rodolfo Bartolome Carrillo Sr. Md NPPES

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

RODOLFO BARTOLOME CARRILLO SR. MD (NPI 1376633586) is an individual general practice provider in Gainesville, Georgia, licensed in Georgia (033243) and active in the NPI registry since October 2006. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1376633586
Entity TypeIndividualMale
Primary Taxonomy208D00000X
Provider Legal NameRODOLFO BARTOLOME CARRILLO SR.Credential: MD
Location Address420 BROAD ST SEGainesville, GA 30501-3726
Mailing Address420 Broad St SeGainesville, GA 30501 · (770) 536-8885 · Fax (770) 536-8725
Phone(770) 536-8885
Fax(770) 536-8725
Sole ProprietorNo
Enumeration DateOctober 16, 2006
Last NPPES UpdateJuly 8, 2007
✔ NPI 1376633586 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyGeneral PracticeAllopathic & Osteopathic Physicians
Taxonomy Code208D00000X
License✔ Licensed in GA · 033243
Definition
A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee
420 BROAD ST SE, Gainesville, GA 30501
Open in Google Maps ↗

Other Identifiers 2

Medicaid0TH000GA
Medicare ID-Type UnspecifiedG14961GA

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Rodolfo Bartolome Carrillo Sr. Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

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 Rodolfo Carrillo's NPI number?

The NPI number for Rodolfo Carrillo is 1376633586. It was assigned to this individual provider in the NPPES registry on October 16, 2006.

Where is Rodolfo Carrillo located?

Rodolfo Carrillo practices at 420 Broad St SE, Gainesville, GA 30501. The listed phone number is (770) 536-8885.

What is Rodolfo Carrillo's specialty?

The primary specialty registered for this NPI is General Practice with taxonomy code 208D00000X.

Is Rodolfo Carrillo enrolled in Medicare?

Yes. Rodolfo Carrillo is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Rodolfo Carrillo was last updated on July 8, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 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.