DR. TIMOTHY WAYNE CARROLL MD
NPI 1437189396
Emergency Medicine in Lexington, KY

Active since July 04, 2006PECOS EnrolledAccepts Medicare Assignment
95.5/100
CMS Quality Rating
1221 S BROADWAY, LEXINGTON, KY 40504(859) 258-4000 Get Directions Write a Review

NPPES record last updated: February 4, 2025. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Dr. Timothy Wayne Carroll Md NPPES

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

DR. TIMOTHY WAYNE CARROLL MD (NPI 1437189396) is an individual emergency medicine provider in Lexington, Kentucky, licensed in Kentucky (32975) and active in the NPI registry since July 2006. He is enrolled in Medicare PECOS, is affiliated with Saint Joseph Hospital, and maintains a secondary practice location in Lexington.

NPPES Registry Identity

NPI1437189396
Entity TypeIndividualMale
Primary Taxonomy207P00000X
Provider Legal NameDR. TIMOTHY WAYNE CARROLLCredential: MD
Location Address1221 S BROADWAYLexington, KY 40504-2701
Mailing Address1221 S BroadwayLexington, KY 40504-2701 · (859) 258-6200 · Fax (859) 258-6203
Sole ProprietorNo
Medical School CMSUniversity Of Kentucky College Of MedicineGraduated 1996
Enumeration DateJuly 4, 2006
Last NPPES UpdateFebruary 4, 2025
NPPES CertifiedFebruary 4, 2025
NPI 1437189396 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyEmergency MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207P00000X
License Licensed in KY · 32975
Definition

An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury.

1221 S BROADWAY, Lexington, KY 40504

Secondary Practice Location 1

Location 1150 N Eagle Creek DrLexington, KY 40509-1805 · Phone (865) 967-5000

Other Identifiers 2

Medicaid64329758KY
Medicaid4329758KY

Accepted 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

Dr. Timothy Wayne Carroll Md 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 ID749251601
PECOS Enrollment IDI20040804000331
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.

Areas of Expertise CMS Part B claims 7

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.

Emergency department visit with moderate level of medical decision making 99284
An emergency department visit for a high-severity issue means you're experiencing a serious health problem that needs immediate attention. This could be a severe injury, serious illness, or life-threatening condition. Medical professionals will provide urgent care to stabilize your condition.
189 services180 patients
Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
110 services108 patients
Emergency department visit with low level of medical decision making 99283
An emergency department visit for a problem of moderate severity involves immediate medical attention for issues like minor fractures, burns, or high fever. The healthcare team will assess your condition, provide necessary treatment, and may suggest further tests or admission if required.
77 services77 patients
Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
47 services47 patients
New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203
This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.
35 services35 patients
Emergency department visit with high level of medical decision making 99285
An emergency department visit for severe conditions is when you urgently seek medical help due to serious health issues. These could be severe injuries, breathing problems, unbearable pain, or sudden severe illness. Doctors and nurses will provide immediate care to stabilize your condition.
25 services25 patients

Hospital Affiliations CMS Care Compare 5

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

Saint Joseph Hospital

Acute Care Hospitals · Lexington, KY
3/5 CMS rating
OwnershipVoluntary non-profit - Church
CMS Certification Number180010
LocationOne Saint Joseph DriveLexington, KY 40504 · Fayette County
Emergency services

Saint Joseph London

Acute Care Hospitals · London, KY
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number180011
Location1001 Saint Joseph LaneLondon, KY 40741 · Laurel County
Emergency services Birthing friendly

Saint Joseph Mount Sterling

Acute Care Hospitals · Mount Sterling, KY
OwnershipVoluntary non-profit - Private
CMS Certification Number180064
Location225 Falcon DriveMount Sterling, KY 40353 · Montgomery County
Emergency services Birthing friendly

Saint Joseph East

Acute Care Hospitals · Lexington, KY
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number180143
Location150 North Eagle Creek DriveLexington, KY 40509 · Fayette County
Emergency services Birthing friendly

Saint Joseph Berea

Critical Access Hospitals · Berea, KY
OwnershipVoluntary non-profit - Private
CMS Certification Number181329
Location305 Estill StreetBerea, KY 40403 · Madison County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 40504 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
$82.24 typical visit price
range $52.76 – $162.27
Typical copayment $20.56 (range $13.19 – $40.56)
Most-billed visit code 99203
Established Patient
$93.94 typical visit price
range $16.53 – $131.99
Typical copayment $23.48 (range $4.13 – $32.99)
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.

95.5/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored through an Alternative Payment Model
Quality89.59
Promoting Interoperability100
Improvement Activities40

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.

Internal Medicine
1221 S BROADWAY, SB-5
LEXINGTON, KY 40504
Otolaryngology
1221 S BROADWAY
LEXINGTON, KY 40504
Radiology (Diagnostic Radiology)
1221 S BROADWAY
LEXINGTON, KY 40504
Internal Medicine (Cardiovascular Disease)
1221 S BROADWAY
LEXINGTON, KY 40504
Radiology (Body Imaging)
1221 S BROADWAY
LEXINGTON, KY 40504
Internal Medicine
1221 S BROADWAY
LEXINGTON, KY 40504
Internal Medicine (Endocrinology, Diabetes & Metabolism)
1221 S BROADWAY
LEXINGTON, KY 40504
Internal Medicine (Endocrinology, Diabetes & Metabolism)
1221 S BROADWAY
LEXINGTON, KY 40504

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 Timothy Carroll's NPI number?

The NPI number for Timothy Carroll is 1437189396. It was assigned to this individual provider in the NPPES registry on July 4, 2006.

Where is Timothy Carroll located?

Timothy Carroll practices at 1221 S Broadway, Lexington, KY 40504. The listed phone number is (859) 258-4000.

What is Timothy Carroll's specialty?

The primary specialty registered for this NPI is Emergency Medicine with taxonomy code 207P00000X.

Is Timothy Carroll enrolled in Medicare?

Yes. Timothy 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.

What insurance does Timothy Carroll accept?

Health plans from CareSource list Timothy Carroll as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Timothy Carroll affiliated with any hospitals?

According to CMS data, Timothy Carroll is affiliated with Saint Joseph Hospital, Saint Joseph London, Saint Joseph Mount Sterling, Saint Joseph East and Saint Joseph Berea.

When was this NPI record last updated?

The NPPES record for Timothy Carroll was last updated on February 4, 2025. NPI Profile syncs with the weekly NPPES data releases published by CMS.