EDWARD JAMES CARROLL (PA-C) – Surgical Physician Assistant, NPI 1083676779

EDWARD JAMES CARROLL (PA-C) is a healthcare provider. based in Lakeland, Florida. specializing in PHYSICIAN ASSISTANT. They hold the professional credentials PA-C. They hold a License No. PA9101893 (FL). The NPI Number for EDWARD JAMES CARROLL (PA-C) is 1083676779

Main info

Male
26 Years Of Experience
Accepts Medicare Assignment
Name
EDWARD JAMES CARROLL (PA-C)
NPI
1083676779
Phone
Not provided
Address
1324 LAKELAND HILLS BLVD.
Enumeration Date
6 April 2006
Last Update Date
1 May 2023

Doctor Profile

Medical School Name
OTHER
Secondary Phone
8636036565
Graduation Year
2000 (26 years ago)
PAC ID
9133395064
Group Practice PAC ID
8325952914
Professional Enrollment ID
I20111227000453
Address ID
FL338051965LA3525XBLVD400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience69
Completeness75
Years active:20State licenses:1Digital endpointsOther names

9,231 PHYSICIAN ASSISTANT in FL

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Provider Addresses for EDWARD JAMES CARROLL (PA-C)

  • Lakeland Regional Health Medical Center, 1324, Lakeland Hills Boulevard, Lakeland, Polk County, Florida, 33805, United States

    ATTN: MANAGED CARE DEPT.

    LAKELAND, FL 33805

    Phone:

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2011-12-27

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20111227000453IPhysician AssistantFLTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 33805)

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Provider's Procedures

EDWARD JAMES CARROLL (PA-C) performs procedures in PHYSICIAN ASSISTANT. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
PHYSICIAN ASSISTANTFL27447Repair of knee joint1616

Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 8325952914View full group profile

Reviews

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Frequently asked questions

Where can patients find EDWARD JAMES CARROLL (PA-C)'s NPI?
You can confirm EDWARD JAMES CARROLL (PA-C) with NPI 1083676779; it appears in the national provider directory.
Does this profile mean EDWARD JAMES CARROLL (PA-C) is currently active?
Yes — EDWARD JAMES CARROLL (PA-C) appears active in the national provider directory.
What field does EDWARD JAMES CARROLL (PA-C) work in?
You can think of EDWARD JAMES CARROLL (PA-C) as practicing within Surgical Physician Assistant. Clinical services aligned with this taxonomy classification.
Where does public data place EDWARD JAMES CARROLL (PA-C)?
The snapshot lists Lakeland, Florida for EDWARD JAMES CARROLL (PA-C); download NPPES for the complete set.
Is EDWARD JAMES CARROLL (PA-C) a real provider?
This page reflects official NPPES data for NPI 1083676779. Always confirm identity and privileges with the practice and licensing boards.

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