Anna Carroll (NPI# 1255729802, PAC ID# 1355661711) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is NURSE PRACTITIONER.
| Nation Provider ID (NPI) | 1255729802 |
| PAC ID by PECOS | 1355661711 |
| Professional Enrollment ID | I20150526002411 |
| Full Name | Anna Carroll |
| Organization Legal Name | HEALTHSOURCE MEDICAL SERVICES MEDFORD, PLLC |
| Address |
1743 N Ocean Ave Medford NY 11763-2649 |
| Phone Number | 6317583100 |
| Gender | F |
| Medical School | STATE UNIVERSITY OF NEW YORK AT STONY BROOK, SCHOOL OF MEDICINE |
| Graduation Year | 2014 |
| Primary Specialty | NURSE PRACTITIONER |
| Group Practice PAC ID | 0143413344 |
| Number of Group Practice Members | 6 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 330141 | BROOKHAVEN MEMORIAL HOSPITAL MEDICAL CENTER |
| Address | Phone | Organization |
|---|---|---|
| 1743 N Ocean Ave, Medford, NY 11763-2649 | 6317583100 | HEALTHSOURCE MEDICAL SERVICES MEDFORD, PLLC |
| 101 Hospital Rd, Patchogue, NY 11772-4870 | 6316547359 | BROOKHAVEN MEMORIAL HOSPITAL MEDICAL CENTER |
| Organization Legal Name | HEALTHSOURCE MEDICAL SERVICES MEDFORD, PLLC |
| Physicians | 7 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Zeeshan Khan | Family Medicine | Healthsource Medical Services Medford, Pllc | 1743 N Ocean Ave, Medford, NY 11763-2649 |
| Michael Ryder | Family Medicine | Healthsource Medical Services Medford, Pllc | 1743 N Ocean Ave, Medford, NY 11763-2649 |
| Kristan Elaina Probeck | Nurse Practitioner | Healthsource Medical Services Medford, Pllc | 1743 N Ocean Ave, Medford, NY 11763-2649 |
| Joan A Scalera | Nurse Practitioner | Healthsource Medical Services Medford, Pllc | 1743 N Ocean Ave, Medford, NY 11763-2649 |
| Annmarie Badagliacca | Physician Assistant | Healthsource Medical Services Medford, Pllc | 1743 N Ocean Ave, Medford, NY 11763-2649 |
| Christine M Aiello | Nurse Practitioner | Healthsource Medical Services Medford, Pllc | 1743 N Ocean Ave, Medford, NY 11763-2649 |
| Street Address |
1743 N OCEAN AVE |
| City | MEDFORD |
| State | NY |
| Zip | 11763-2649 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Zeeshan Khan | Family Medicine | Healthsource Medical Services Medford, Pllc | 1743 N Ocean Ave, Medford, NY 11763-2649 |
| Michael Ryder | Family Medicine | Healthsource Medical Services Medford, Pllc | 1743 N Ocean Ave, Medford, NY 11763-2649 |
| Kristan Elaina Probeck | Nurse Practitioner | Healthsource Medical Services Medford, Pllc | 1743 N Ocean Ave, Medford, NY 11763-2649 |
| Joan A Scalera | Nurse Practitioner | Healthsource Medical Services Medford, Pllc | 1743 N Ocean Ave, Medford, NY 11763-2649 |
| Annmarie Badagliacca | Physician Assistant | Healthsource Medical Services Medford, Pllc | 1743 N Ocean Ave, Medford, NY 11763-2649 |
| Christine M Aiello | Nurse Practitioner | Healthsource Medical Services Medford, Pllc | 1743 N Ocean Ave, Medford, NY 11763-2649 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Emily F Chappell | Clinical Social Worker | 3239 Route 112 5, Medford, NY 11763-1432 | |
| Raj D Tolat | Physical Medicine and Rehabilitation | 2920 Route 112, Medford, NY 11763-1451 | |
| Isaac J Alamuri | Family Medicine | 23 Bloomington St, Medford, NY 11763-1579 | |
| Sang H Song | Physical Medicine and Rehabilitation | 700 Patchogue Yaphank Rd, Suite 49, Medford, NY 11763-2239 | |
| Muhammad Imran | Physical Therapy | 700 Patchogue Yaphank Rd, Suite 49, Medford, NY 11763-2239 | |
| Jennifer L Wellman | Occupational Therapy | Home Advantage Occupational Therapy, P.C. | 12 Platinum Court, Medford, NY 11763-2247 |
| Cydney E Taylor | Physician Assistant | Prince Medicine PC | 12 Platinum Ct, Medford, NY 11763-2247 |
| Randy Lee Parr | Physician Assistant | Prince Medicine PC | 12 Platinum Ct, Medford, NY 11763-2247 |
| Scott Richard Lindsay | Physical Therapy | Evolution Home Physical Therapy, P.C. | 12 Platinum Ct, Medford, NY 11763-2247 |
| David Nieves | Physical Therapy | Evolution Home Physical Therapy, P.C. | 12 Platinum Ct, Medford, NY 11763-2247 |
| Find all physicians in zip 11763 | |||
| City | MEDFORD |
| Zip Code | 11763 |
| Specialty | NURSE PRACTITIONER |
| City + Specialty | MEDFORD + NURSE PRACTITIONER |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.