NICOLE CARROLL D.O.
NPI 1649593500
Family Medicine in Shippenville, PA

Q: What is Nicole Carroll's NPI number?

The NPI number for Nicole Carroll is 1649593500. It was assigned to this individual provider in the NPPES registry on March 8, 2010.

Q: What is Nicole Carroll's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Q: When was this NPI record last updated?

The NPPES record for Nicole Carroll was last updated on July 10, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 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 March 08, 2010PECOS EnrolledAccepts Medicare Assignment

21159 PAINT BLVD, SUITE 2, SHIPPENVILLE, PA 16254(814) 226-6770 Get Directions Write a Review

NPPES record last updated: July 10, 2012. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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About Nicole Carroll D.o. NPPES

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

NICOLE CARROLL D.O. (NPI 1649593500) is an individual family medicine provider in Shippenville, Pennsylvania, licensed in Pennsylvania (OS015672) and active in the NPI registry since March 2010. She is enrolled in Medicare PECOS, is affiliated with Upmc Northwest, and is a graduate of Lake Erie College Of Osteopathic Medicine, Erie (2009).

NPPES Registry Identity

NPI1649593500

Entity TypeIndividualFemale

Primary Taxonomy207Q00000X

Provider Legal NameNICOLE CARROLLCredential: D.O.

Location Address21159 PAINT BLVD, SUITE 2Shippenville, PA 16254-4023

Mailing Address121 Doctors LnClarion, PA 16214-8515 · (814) 226-3470 · Fax (814) 226-3479

Phone(814) 226-6770

Sole ProprietorNo

Medical School CMSLake Erie College Of Osteopathic Medicine, ErieGraduated 2009

Enumeration DateMarch 8, 2010

Last NPPES UpdateJuly 10, 2012

✔ NPI 1649593500 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207Q00000X

License✔ Licensed in PA · OS015672

Definition

Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

21159 PAINT BLVD, Shippenville, PA 16254

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Other Identifiers 1

Medicaid1026314130003PA

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter Health, Ambetter Health of Delaware.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

Nicole Carroll D.o. 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 ID5597937862

PECOS Enrollment IDI20111010000254

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 14

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.

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.

270 services148 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.

141 services101 patients

Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439

An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.

96 services96 patients

Injection of drug or substance under skin or into muscle 96372

This procedure involves administering medication directly under the skin or into a muscle. A small needle is used to inject the drug, allowing it to be absorbed quickly into the bloodstream. It's a common method for delivering a variety of medications.

81 services25 patients

Administration of influenza virus vaccine G0008

The administration of the influenza virus vaccine, also known as the flu shot, is a simple procedure to protect against the flu. A healthcare provider injects a small dose of the vaccine into your arm. This stimulates your immune system to produce antibodies, which will help your body fight off the flu if exposed.

58 services57 patients

Influenza vaccine split virus, preservative free 90662

The Influenza Vaccine Split Virus, preservative-free, is a flu shot to protect against the influenza virus. It is made from parts of inactivated flu viruses and doesn't contain preservatives, reducing potential side effects. It helps your body develop immunity to the flu.

54 services53 patients

Injection, vitamin b-12 cyanocobalamin, up to 1000 mcg J3420

This is a procedure where a small dose of Vitamin B-12, also known as Cyanocobalamin, is injected into your body. This vitamin is essential for nerve function and the production of red blood cells. It's often used to treat vitamin B-12 deficiency.

46 services13 patients

Pneumococcal conjugate vaccine, 20 valent (pcv20), for intramuscular use 90677

The Pneumococcal Conjugate Vaccine (PCV20) is a shot given to protect against 20 types of bacteria that can cause serious infections like pneumonia and meningitis. It's administered through a muscle, usually in the arm. It's important for overall health.

45 services45 patients

Administration of pneumococcal vaccine G0009

The pneumococcal vaccine helps protect against pneumococcal bacteria, which can cause severe infections like pneumonia and meningitis. The vaccine is given as an injection, typically in the arm. It's recommended for infants, older adults, and those with certain health conditions.

45 services45 patients

Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit G0438

An annual wellness visit is a yearly appointment with your doctor to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's an opportunity to discuss your health status and goals and get a plan tailored for you.

21 services21 patients

Urinalysis, manual test 81002

A urinalysis is a simple, non-invasive test that checks the urine for various elements such as sugar, protein, and signs of infection. It can help detect many common conditions, including kidney disease and diabetes. The manual test involves a lab technician examining a urine sample.

14 services11 patients

Initial preventive physical examination; face-to-face visit, services limited to new beneficiary during the first 12 months of medicare enrollment G0402

An Initial Preventive Physical Examination, also known as a "Welcome to Medicare" visit, is a one-time, face-to-face visit during your first 12 months of Medicare enrollment. It includes a review of your health, as well as education and counseling about preventive services and further screenings.

14 services14 patients

Transitional care management services for problem of at least moderate complexity 99495

Transitional care management services focus on coordinating and managing your care after you leave the hospital. For moderate complexity problems, this involves managing your medications, arranging further treatments, and ensuring you have the necessary follow-ups.

13 services12 patients

Detection test by immunoassay technique for severe acute respiratory syndrome coronavirus and influenza 87428

This test uses a method called immunoassay to identify severe acute respiratory syndrome coronavirus and influenza. It works by detecting specific proteins (antigens) in a sample, like a nasal swab. It's a powerful tool in diagnosing these viral infections.

12 services12 patients

Hospital Affiliations CMS Care Compare 3

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

Upmc Northwest

Acute Care Hospitals · Seneca, PA

4/5 CMS rating

OwnershipVoluntary non-profit - Other

CMS Certification Number390091

Location100 Fairfield DriveSeneca, PA 16346 · Venango County

Emergency services Birthing friendly

Clarion Hospital

Acute Care Hospitals · Clarion, PA

OwnershipVoluntary non-profit - Private

CMS Certification Number390093

LocationOne Hospital DriveClarion, PA 16214 · Clarion County

Emergency services

Butler Memorial Hospital

Acute Care Hospitals · Butler, PA

2/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number390168

LocationOne Hospital WayButler, PA 16001 · Butler County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 16254 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

$84.88 typical visit price

range $54.64 – $166.87

Typical copayment $21.22 (range $13.66 – $41.71)

Most-billed visit code 99203

Established Patient

$96.82 typical visit price

range $17.33 – $135.84

Typical copayment $24.20 (range $4.33 – $33.96)

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.

Reported Quality Measures

Care Plan

Percentage of patients aged 65 years and older who have an advance care plan or surrogate decision maker documented in the medical record that an advance care plan was discussed but the patient did not wish or was not able to name a surrogate decision maker…

67%182 patients3/55-star benchmark: 100%

Colorectal Cancer Screening

Percentage of adults 50-75 years of age who had appropriate screening for colorectal cancer

62%128 patients3/55-star benchmark: 100%

Diabetes: Eye Exam

Percentage of patients 18-75 years of age with diabetes who had a retinal or dilated eye exam by an eye care professional during the measurement period or a negative retinal exam (no evidence of retinopathy) in the 12 months prior to the measurement period

35%20 patients1/55-star benchmark: 100%

Pneumococcal Vaccination Status for Older Adults

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

74%176 patients3/55-star benchmark: 100%

Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan

Percentage of patients aged 18 years and older with a BMI documented during the current encounter or during the previous twelve months AND with a BMI outside of normal parameters, a follow-up plan is documented during the encounter or during the previous…

38%208 patients2/55-star benchmark: 100%

Preventive Care and Screening: Screening for Depression and Follow-Up Plan

Percentage of patients aged 12 years and older screened for depression on the date of the encounter using an age appropriate standardized depression screening tool AND if positive, a follow-up plan is documented on the date of the positive screen

72%174 patients3/55-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 11

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

Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253

DME-Other DME · category DE017N

3 suppliers26 claims45 services$5.56 avg. paid by Medicare

Tubing with integrated heating element for use with positive airway pressure device A4604