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NICOLE CARRILLO
NPI 1942695796
Emergency Medicine in Fort Worth, TX

Active since March 30, 2015PECOS EnrolledAccepts Medicare Assignment
1500 S MAIN ST, FORT WORTH, TX 76104(817) 702-3431 Get Directions Write a Review

NPPES record last updated: March 6, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Mar 6, 2025, Dec 10, 2018, Dec 7, 2017 (3 updates tracked since 2017).

About Nicole Carrillo NPPES

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

NICOLE CARRILLO (NPI 1942695796) is an individual emergency medicine provider in Fort Worth, Texas, licensed in Texas (R4460) and active in the NPI registry since March 2015. She is enrolled in Medicare PECOS, is affiliated with Baylor Scott & White Medical Center- Waxahachie, and is a graduate of Arizona College Of Osteopathic Medicine Mid Western University (2015).

NPPES Registry Identity

NPI1942695796
Entity TypeIndividualFemale
Primary Taxonomy207P00000X
Provider Legal NameNICOLE CARRILLO
Location Address1500 S MAIN STFort Worth, TX 76104-4917
Mailing Address1500 S Main StFort Worth, TX 76104-4917 · (817) 702-3431
Phone(817) 702-3431
Sole ProprietorNo
Medical School CMSArizona College Of Osteopathic Medicine Mid Western UniversityGraduated 2015
Enumeration DateMarch 30, 2015
Last NPPES UpdateMarch 6, 20253 updates tracked since enumeration
NPPES CertifiedMarch 6, 2025
✔ NPI 1942695796 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyEmergency MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207P00000X
License✔ Licensed in TX · R4460
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.
1500 S MAIN ST, Fort Worth, TX 76104
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of Texas, Oscar Insurance Company.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 Carrillo 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 ID2163783788
PECOS Enrollment IDI20180222001989
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 5

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 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.
288 services278 patients
Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report only 93010
A routine electrocardiogram (ECG) with 12 leads is a simple, non-invasive test that records the electrical activity of your heart. It helps in identifying heart conditions by detecting irregularities in your heart rhythms. The results are interpreted and a report is provided.
217 services196 patients
Critical care, first 30-74 minutes 99291
Critical care involves immediate and constant attention by a team of specially-trained health professionals. It's for patients with life-threatening conditions, requiring first 30-74 minutes of intense monitoring and treatment.
92 services90 patients
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.
50 services50 patients
Electrocardiogram (ecg) 1 to 3 leads with review by physician only 93042
An Electrocardiogram (ECG) is a non-invasive test that records the electrical activity of your heart. 1 to 3 leads or sensors are placed on your body to capture this data. A physician then reviews the results to evaluate your heart's health.
14 services14 patients

Hospital Affiliations CMS Care Compare 2

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

Baylor Scott & White Medical Center- Waxahachie

Acute Care Hospitals · Waxahachie, TX
5/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number450372
Location2400 N Interstate Highway 35EWaxahachie, TX 75165 · Ellis County
Emergency services Birthing friendly

Texas Health Huguley Hospital Fort Worth South

Acute Care Hospitals · Burleson, TX
3/5 CMS rating
OwnershipVoluntary non-profit - Church
CMS Certification Number450677
Location11801 South FreewayBurleson, TX 76028 · Johnson County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 76104 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
$87.20 typical visit price
range $56.47 – $171.07
Typical copayment $21.80 (range $14.11 – $42.76)
Most-billed visit code 99203
Established Patient
$99.68 typical visit price
range $18.18 – $139.68
Typical copayment $24.92 (range $4.54 – $34.92)
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.

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.

JONATHAN A LAZARINI MD
Family Medicine
1500 S MAIN ST
FORT WORTH, TX 76104
Tarrant County (903) 353-2265
ALLYSON EVANS
Nurse Anesthetist, Certified Registered
1500 S MAIN ST
FORT WORTH, TX 76104
Tarrant County (801) 792-5267
DR. TREVOR A JOHNSON MD
Family Medicine
1500 S MAIN ST
FT WORTH, TX 76104
Tarrant County (817) 702-3431
DR. LELIA ERRETT WILLIAMS MD
Student in an Organized Health Care Education/Training Program
1500 S MAIN ST
FORT WORTH, TX 76104
Tarrant County (817) 702-1244
MITCHELL JOHNSON
Student in an Organized Health Care Education/Training Program
1500 S MAIN ST
FORT WORTH, TX 76104
Tarrant County (817) 702-1100
RIDDHI RANE MD
Student in an Organized Health Care Education/Training Program
1500 S MAIN ST
FORT WORTH, TX 76104
Tarrant County (817) 702-6500
DR. JOANE BAUMER M.D.
Family Medicine
1500 S MAIN ST, FAMILY MEDICINE CENTER
FORT WORTH, TX 76104
Tarrant County (817) 335-1034
SHARYL WORKMAN PA
Physician Assistant
1500 S MAIN ST
FORT WORTH, TX 76104
Tarrant County (817) 927-1100

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 Nicole Carrillo's NPI number?

The NPI number for Nicole Carrillo is 1942695796. It was assigned to this individual provider in the NPPES registry on March 30, 2015.

Where is Nicole Carrillo located?

Nicole Carrillo practices at 1500 S Main St, Fort Worth, TX 76104. The listed phone number is (817) 702-3431.

What is Nicole Carrillo's specialty?

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

Is Nicole Carrillo enrolled in Medicare?

Yes. Nicole Carrillo 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 Nicole Carrillo accept?

Health plans from Blue Cross and Blue Shield of Texas and Oscar Insurance Company list Nicole Carrillo 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 Nicole Carrillo affiliated with any hospitals?

According to CMS data, Nicole Carrillo is affiliated with Baylor Scott & White Medical Center- Waxahachie and Texas Health Huguley Hospital Fort Worth South.

When was this NPI record last updated?

The NPPES record for Nicole Carrillo was last updated on March 6, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 months 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.