DR. EDMUND THOMAS CARROLL III D.O.
NPI 1629029749
Orthopaedic Surgery in Lewes, DE

Q: What is Edmund Carroll's NPI number?

The NPI number for Edmund Carroll is 1629029749. It was assigned to this individual provider in the NPPES registry on May 13, 2006.

Q: What is Edmund Carroll's specialty?

The primary specialty registered for this NPI is Orthopaedic Surgery with taxonomy code 207X00000X.

Q: When was this NPI record last updated?

The NPPES record for Edmund Carroll was last updated on January 23, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.

Active since May 13, 2006PECOS Enrolled

80.07/100

CMS Quality Rating

12100 BLACK SWAN DRIVE, SUITE 201, LEWES, DE 19958(302) 644-3311(302) 644-3300 Get Directions Write a Review

NPPES record last updated: January 23, 2020. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jan 23, 2020, Feb 16, 2018 (2 updates tracked since 2018).

On this page

About Dr. Edmund Thomas Carroll Iii D.o. NPPES

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

DR. EDMUND THOMAS CARROLL III D.O. (NPI 1629029749) is an individual orthopaedic surgery provider in Lewes, Delaware, licensed in Delaware (C20007511) and active in the NPI registry since May 2006. He is enrolled in Medicare PECOS and maintains a secondary practice location in Lewes.

NPPES Registry Identity

NPI1629029749

Entity TypeIndividualMale

Primary Taxonomy207X00000X

Provider Legal NameDR. EDMUND THOMAS CARROLL IIICredential: D.O.

Location Address12100 BLACK SWAN DRIVE, SUITE 201Lewes, DE 19958-4988

Mailing Address211 Executive Dr Ste 11Newark, DE 19702-3358 · (302) 451-6913 · Fax (302) 368-7756

Phone(302) 644-3311

Fax(302) 644-3300

Sole ProprietorNo

Enumeration DateMay 13, 2006

Last NPPES UpdateJanuary 23, 20202 updates tracked since enumeration

✔ NPI 1629029749 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOrthopaedic SurgeryAllopathic & Osteopathic Physicians

Taxonomy Code207X00000X

License✔ Licensed in DE · C20007511

Definition

An orthopaedic surgeon is trained in the preservation, investigation and restoration of the form and function of the extremities, spine and associated structures by medical, surgical and physical means. An orthopaedic surgeon is involved with the care of patients whose musculoskeletal problems include congenital deformities, trauma, infections, tumors, metabolic disturbances of the musculoskeletal system, deformities, injuries and degenerative diseases of the spine, hands, feet, knee, hip, shoulder and elbow in children and adults. An orthopaedic surgeon is also concerned with primary and secondary muscular problems and the effects of central or peripheral nervous system lesions of the musculoskeletal system.

12100 BLACK SWAN DRIVE, Lewes, DE 19958

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Secondary Practice Location 1

Location 117005 Old Orchard RdLewes, DE 19958-4828 · Phone (302) 644-3311 · Fax (302) 644-3300

Other Identifiers 15

Other204955Unison Health Plan

Other3638665Aetna Us Healthcare

Other51-0370286Union Labor Life Insurance Company

Other51-0370286United Healthcare

Other2129304Onenet Ppo, Mamsi, Optimum Choice

Other51-0370286Devon Health Services

Other51-0370286Corvel/corcare

Other1184681488Commercial Insurances

Other51-0343207Blue Cross Blue Shield Of Delaware

Other51-0370286Cigna

Medicaid1000035330DE

Other2356448000Amerihealth

Other51-0370286Health Net - Tricare/champus

Other51-0370286Great-west Healthcare

OtherP00247768Railroad Medicare

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include AmeriHealth Caritas Next.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Edmund Thomas Carroll Iii D.o. 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.

Areas of Expertise CMS Part B claims 17

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.

Hyaluronan or derivative, trivisc, for intra-articular injection, 1 mg J7329

Trivisc is a treatment involving injections of a substance called hyaluronan into your joint, typically the knee. This substance is similar to a natural fluid in your joints that helps cushion and lubricate them. Trivisc can help reduce pain and improve joint movement.

5,129 services45 patients

Injection, triamcinolone acetonide, not otherwise specified, 10 mg J3301

Triamcinolone acetonide is a medication used to reduce inflammation in the body. It's given as a 10 mg injection for conditions like allergies, arthritis, or skin problems. The injection helps to decrease swelling, redness, and itching.

3,856 services670 patients

X-ray of knee, 3 views 73562

An X-ray of the knee, 3 views, is a non-invasive imaging test. It uses a small amount of radiation to produce images of the knee from three different angles. This helps medical professionals to diagnose and monitor conditions like arthritis, fractures, or infections. The process is quick and painless.

1,133 services622 patients

Aspiration and/or injection of fluid from large joint 20610

This procedure involves using a needle to remove (aspiration) or introduce (injection) fluid into a large joint like the knee or hip. It can help diagnose conditions, relieve discomfort, or deliver medication directly to the joint.

1,020 services574 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.

741 services530 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.

604 services456 patients

Aspiration and/or injection of fluid large joint using ultrasound guidance 20611

This procedure involves using ultrasound technology to accurately locate a large joint, usually the knee or shoulder. A needle is then inserted to either extract fluid (aspiration) or inject medication. The ultrasound helps ensure precision and safety.

242 services174 patients

X-ray of hip, 2-3 views 73502

An X-ray of the hip with 2-3 views is a non-invasive imaging test. It uses a small amount of radiation to produce pictures of the hip joint. These images help in diagnosing conditions like fractures, arthritis, or other abnormalities. The process is quick and painless.

219 services177 patients

New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204

This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.

174 services174 patients

X-ray of knee, 1-2 views 73560

An X-ray of the knee with 1-2 views is a quick, painless test that produces images of the knee bones. It helps identify fractures, infections, or changes in the knee joint. During the procedure, you'll be asked to stay still while the X-ray machine captures the images.

113 services95 patients

Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more 99212

This is a routine check-up for patients who have previously seen the doctor. During this 10-19 minute visit, the doctor will review your health status, discuss any concerns, and manage ongoing treatments or medications. It's a chance to ensure your health is on track.

112 services107 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.

88 services88 patients

X-ray of both knees while standing 73565

An X-ray of both knees while standing is a diagnostic procedure that captures images of your knee joints. You'll stand in front of an X-ray machine, and it will take pictures showing the bones and tissues in your knees. This helps doctors identify any abnormalities or injuries.

42 services41 patients

X-ray of both hips, minimum of 5 views 73523

An X-ray of both hips with a minimum of 5 views is a non-invasive imaging test. It uses a small amount of radiation to produce images of the hip joints from different angles. This aids in diagnosing conditions such as fractures, arthritis, or other hip abnormalities.

37 services23 patients

Replacement of knee joint, both sides of knee 27447

A bilateral knee joint replacement is a procedure where the damaged parts of both your knee joints are replaced with artificial parts. It aims to relieve pain and improve mobility. The process involves a surgical operation under anesthesia.

34 services31 patients

X-ray of lower and sacral spine, 2-3 views 72100

An X-ray of the lower and sacral spine involves capturing images of your lower back area, including the tailbone. This procedure helps in identifying problems like fractures, infections, or deformities. 2-3 different angle views provide a comprehensive picture.

27 services27 patients

Removal of knee cartilage using an endoscope 29881

This procedure, known as arthroscopic knee surgery, involves using a small camera (endoscope) to view the inside of your knee. Small instruments are used to remove damaged cartilage. This can help alleviate pain and improve knee function.

13 services13 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 19958 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

$88.37 typical visit price

range $57.12 – $173.08

Typical copayment $22.09 (range $14.28 – $43.27)

Most-billed visit code 99203

Established Patient

$71.19 typical visit price

range $18.36 – $141.05

Typical copayment $17.79 (range $4.59 – $35.26)

Most-billed visit code 99213

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.

80.07/100

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

Scored as part of a group practice

Quality

78.59

Promoting Interoperability

100

Improvement Activities

Cost

54.98

Reported Quality Measures

Closing the Referral Loop: Receipt of Specialist Report

Percentage of patients with referrals, regardless of age, for which the referring provider receives a report from the provider to whom the patient was referred

97%39 patients5/55-star benchmark: 95%

Diabetes: Medical Attention for Nephropathy

The percentage of patients 18-75 years of age with diabetes who had a nephropathy screening test or evidence of nephropathy during the measurement period

67%52 patients3/55-star benchmark: 99%

Documentation of Current Medications in the Medical Record

Percentage of visits for patients aged 18 years and older for which the eligible professional or eligible clinician attests to documenting a list of current medications using all immediate resources available on the date of the encounter.

100%3,920 patients5/55-star benchmark: 100%

e-Prescribing

At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology.

97%1,138 patients4/55-star benchmark: 100%

Medication Reconciliation

The MIPS eligible clinician performs medication reconciliation for at least one transition of care in which the patient is transitioned into the care of the MIPS eligible clinician.

99%834 patients4/55-star benchmark: 100%

Patient-Specific Education

The MIPS eligible clinician must use clinically relevant information from CEHRT to identify patient-specific educational resources and provide access to those materials to at least one unique patient seen by the MIPS eligible clinician.

99%2,195 patients5/55-star benchmark: 99%

Pneumococcal Vaccination Status for Older Adults

Percentage of patients 65 years of age and older who have ever received a pneumococcal vaccine

57%1,275 patients3/55-star benchmark: 90%

Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention

Percentage of patients aged 18 years and older who were screened for tobacco use one or more times within 24 months AND who received tobacco cessation intervention if identified as a tobacco user

Patients screenedForUse: 91% · 1,379 patients

91%1,379 patients4/55-star benchmark: 98%

Provide Patient Access

At least one patient seen by the MIPS eligible clinician during the performance period is provided timely access to view online, download, and transmit to a third party their health information subject to the MIPS eligible clinician's discretion to withhold…

64%2,175 patients3/55-star benchmark: 100%

Secure Messaging

For at least one unique patient seen by the MIPS eligible clinician during the performance period, a secure message was sent using the electronic messaging function of CEHRT to the patient (or the patient-authorized representative), or in response to a secure…

0%2,175 patients1/55-star benchmark: 59%

Use of High-Risk Medications in the Elderly

Percentage of patients 65 years of age and older who were ordered high-risk medications. Two rates are submitted. 1) Percentage of patients who were ordered at least one high-risk medication.

Lower rates are better for this measure.

Patients 2+: 0% · 1,275 patients

0%1,275 patients5/55-star benchmark: 100%

Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

Referred Medical Equipment & Supplies CMS DME claims 3

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

Walker, folding, wheeled, adjustable or fixed height E0143

DME-Other DME · category DE000N

2 suppliers32 claims32 services$50.51 avg. paid by Medicare

Commode chair, mobile or stationary, with fixed arms E0163

DME-Other DME · category DE000N

2 suppliers24 claims24 services$52.18 avg. paid by Medicare

Neuromuscular stimulator, electronic shock unit E0745

DME-Other DME · category DE000N

1 supplier48 claims48 services$65.04 avg. paid by Medicare

Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

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Other Providers at the Same Location NPPES 13

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

DALE F. SUTHERLAND M.D.

Anesthesiology