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DR. THOMAS MARK CARROLL II M.D., PH.D.
NPI 1902078413
Internal Medicine in Rochester, NY

Active since March 25, 2008PECOS EnrolledAccepts Medicare Assignment
85.17/100
CMS Quality Rating
601 ELMWOOD AVE, BOX MED, ROCHESTER, NY 14642(585) 275-7424(585) 273-1069 Get Directions Write a Review

NPPES record last updated: July 6, 2023. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Dr. Thomas Mark Carroll Ii M.d., Ph.d. NPPES

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

DR. THOMAS MARK CARROLL II M.D., PH.D. (NPI 1902078413) is an individual internal medicine provider in Rochester, New York, licensed in New York (257277) and active in the NPI registry since March 2008. He is enrolled in Medicare PECOS, is affiliated with Highland Hospital, and is a graduate of University Of Connecticut School Of Medicine (2008).

NPPES Registry Identity

NPI1902078413
Entity TypeIndividualMale
Primary Taxonomy207R00000X
Provider Legal NameDR. THOMAS MARK CARROLL IICredential: M.D., PH.D.
Location Address601 ELMWOOD AVE, BOX MEDRochester, NY 14642-0001
Mailing Address601 Elmwood Ave, Box MedRochester, NY 14642-0001 · (585) 275-7424 · Fax (585) 273-1069
Phone(585) 275-7424
Fax(585) 273-1069
Sole ProprietorNo
Medical School CMSUniversity Of Connecticut School Of MedicineGraduated 2008
Enumeration DateMarch 25, 2008
Last NPPES UpdateJuly 6, 2023
✔ NPI 1902078413 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
License✔ Licensed in NY · 257277
Definition
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
Also ListedInternal Medicine · Hospice and Palliative MedicineTaxonomy 207RH0002X · License 257277 (NY)
Also ListedHospitalistTaxonomy 208M00000X · License 257277 (NY)
601 ELMWOOD AVE, Rochester, NY 14642
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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. Thomas Mark Carroll Ii M.d., Ph.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 ID9335326180
PECOS Enrollment IDI20110606000140
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

4

Medicare enrollment records show Thomas Carroll reassigns Medicare billing to 4 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Internal Medicine Group
Same address
Internal Medicine
601 ELMWOOD AVE
Rochester, NY 14642
  • Reassigned Medicare billing, New York enrollment
  • 302 clinicians in this Medicare group
NPI 1649220393 (585) 275-4912
Strong Palliative Care Group
Same address
Hospice and Palliative Medicine
601 ELMWOOD AVE, BOX 601
Rochester, NY 14642
  • Reassigned Medicare billing, New York enrollment
  • 34 clinicians in this Medicare group
NPI 1144260001 (585) 273-1154
University Of Rochester
Same address
General Acute Care Hospital
601 ELMWOOD AVE, BOX 684
Rochester, NY 14642
  • Reassigned Medicare billing, New York enrollment
  • 1,624 clinicians in this Medicare group
NPI 1346285657 (585) 275-2100
Highland Hospital Of Rochester
1.2 mi
Internal Medicine
1000 SOUTH AVE
Rochester, NY 14620
  • Reassigned Medicare billing, New York enrollment
  • 303 clinicians in this Medicare group
NPI 1376820241 (585) 473-2200

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 4

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 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.
91 services76 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.
36 services29 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.
27 services13 patients
Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more 99215
This service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.
14 services12 patients

Hospital Affiliations CMS Care Compare 2

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

Highland Hospital

Acute Care Hospitals · Rochester, NY
2/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number330164
Location1000 South AvenueRochester, NY 14617 · Monroe County
Emergency services Birthing friendly

Strong Memorial Hospital

Acute Care Hospitals · Rochester, NY
2/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number330285
Location601 Elmwood AveRochester, NY 14642 · Monroe County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 14642 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
$126.40 typical visit price
range $54.87 – $166.88
Typical copayment $31.60 (range $13.71 – $41.72)
Most-billed visit code 99204
Established Patient
$97.08 typical visit price
range $17.54 – $136.14
Typical copayment $24.27 (range $4.38 – $34.03)
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.

85.17/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality70.92
Promoting Interoperability100
Improvement Activities40
Cost62.98

Referred Medical Equipment & Supplies CMS DME claims 6

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

Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing A6402
DME-Medical/Surgical Supplies · category DA023N
1 supplier12 claims600 services$0.11 avg. paid by Medicare
Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape B4035
Other-Enteral and Parenteral · category OB006N
1 supplier12 claims360 services$4.07 avg. paid by Medicare
Enteral formula, nutritionally complete with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit B4150
Other-Enteral and Parenteral · category OB006N
1 supplier12 claims4,320 services$0.32 avg. paid by Medicare
Iv pole E0776
DME-Other DME · category DE000N
1 supplier12 claims12 services$8.19 avg. paid by Medicare
Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 1 mg J7613
DME-Drugs Administered Through DME · category DG006N
2 suppliers11 claims341 services$0.04 avg. paid by Medicare
Pharmacy dispensing fee for inhalation drug(s); per 30 days Q0513
DME-Other DME · category DE000N
3 suppliers12 claims12 services$23.94 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 20

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

CARIE E BRADT RPA-C
Physician Assistant
601 ELMWOOD AVE
ROCHESTER, NY 14642
Monroe County (585) 275-6070
DR. RITA DADIZ DO
Pediatrics (Neonatal-Perinatal Medicine)
601 ELMWOOD AVE, BOX 635
ROCHESTER, NY 14642
Monroe County (585) 275-7787
DR. SCOTT ROSS SCHIFFMAN M.D.
Radiology (Diagnostic Radiology)
601 ELMWOOD AVE, BOX 648
ROCHESTER, NY 14642
Monroe County (585) 275-1128
SARAH ANNE ROSSI FNP
Nurse Practitioner (Family)
601 ELMWOOD AVE, BOX 652
ROCHESTER, NY 14642
Monroe County (585) 279-5100
JIMENA CUBILLOS MD
Urology (Pediatric Urology)
601 ELMWOOD AVE, BOX 656
ROCHESTER, NY 14642
Monroe County (585) 275-3342
MRS. ANNE SCHERBERGER KEEFER RN NP
Nurse Practitioner (Adult Health)
601 ELMWOOD AVE, BOX 704
ROCHESTER, NY 14642
Monroe County (585) 275-5307
SCOTT OVERHOLT DDS
Student in an Organized Health Care Education/Training Program
601 ELMWOOD AVE, BOX 705
ROCHESTER, NY 14642
Monroe County (585) 275-7978
MS. SARAH L AVERILL MD
Radiology (Diagnostic Radiology)
601 ELMWOOD AVE
ROCHESTER, NY 14642
Monroe County (585) 275-2100

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 Thomas Carroll's NPI number?

The NPI number for Thomas Carroll is 1902078413. It was assigned to this individual provider in the NPPES registry on March 25, 2008.

Where is Thomas Carroll located?

Thomas Carroll practices at 601 Elmwood Ave Box Med, Rochester, NY 14642. The listed phone number is (585) 275-7424.

What is Thomas Carroll's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Is Thomas Carroll enrolled in Medicare?

Yes. Thomas 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 Thomas Carroll's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Thomas Carroll reassigns Medicare benefits to 4 organizations: Internal Medicine Group (Rochester, NY), Strong Palliative Care Group (Rochester, NY), University Of Rochester (Rochester, NY) and Highland Hospital Of Rochester (Rochester, NY). 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 Thomas Carroll's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

Is Thomas Carroll affiliated with any hospitals?

According to CMS data, Thomas Carroll is affiliated with Highland Hospital and Strong Memorial Hospital.

When was this NPI record last updated?

The NPPES record for Thomas Carroll was last updated on July 6, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.