BRENDAN CARGILL CARROLL (MD) – Obstetrics & Gynecology Physician, NPI 1669472775

BRENDAN CARGILL CARROLL (MD) is a healthcare provider. based in Portland, Oregon. specializing in OBSTETRICS/GYNECOLOGY. They hold the professional credentials MD. They hold a License No. MD21047 (OR). The NPI Number for BRENDAN CARGILL CARROLL (MD) is 1669472775

Main info

Male
32 Years Of Experience
Accepts Medicare Assignment
Name
BRENDAN CARGILL CARROLL (MD)
NPI
1669472775
Phone
Not provided
Address
PO BOX 3158
Enumeration Date
29 July 2005
Last Update Date
18 February 2021

Doctor Profile

Medical School Name
GEORGETOWN UNIVERSITY SCHOOL OF MEDICINE
Secondary Phone
5032156262
Graduation Year
1994 (32 years ago)
PAC ID
3678656444
Group Practice PAC ID
0648183608
Professional Enrollment ID
I20080303000367
Address ID
OR972132237PO545XXAVEX412

Contacts

Secure Messaging
bcarroll132923@oc.providencedirect.org
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience64
Completeness85
Years active:20State licenses:1Other namesUpdated within 12 months

632 OBSTETRICS/GYNECOLOGY in OR

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Provider Addresses for BRENDAN CARGILL CARROLL (MD)

  • 3158, Southwest 87th Avenue, Portland, Metro, Washington County, Oregon, 97225, United States

    PORTLAND, OR 972083158

    Phone:

    Type: Mailing

  • Providence Portland Medical Center, 4805, Northeast Glisan Street, North Tabor, Portland, Metro, Multnomah County, Oregon, 97213, United States

    UNIT 3K

    PORTLAND, OR 972132933

    Phone: (503) 215-6150

    Type: Location

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: 2008-03-03

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
I20080303000367IObstetrics/GynecologyORTBD

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 97208)

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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: 0648183608View full group profile
NameSpecialtyState
Internal MedicineOR
Physician AssistantOR
Nurse PractitionerOR
-OR
N E U R O L O G YOR
Nurse PractitionerOR
Infectious Disease, Internal MedicineOR
Thoracic SurgeryOR
Nurse PractitionerOR
Physician AssistantWA

Reviews

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Frequently asked questions

How do payers reference BRENDAN CARGILL CARROLL (MD)?
For BRENDAN CARGILL CARROLL (MD), use NPI 1669472775 as the unique 10-digit identifier.
Active or inactive — what applies to BRENDAN CARGILL CARROLL (MD)?
You should see BRENDAN CARGILL CARROLL (MD) as active in CMS-hosted NPPES data.
How would a patient describe BRENDAN CARGILL CARROLL (MD)'s focus?
For BRENDAN CARGILL CARROLL (MD), the primary taxonomy reads as Obstetrics & Gynecology Physician. Clinical services aligned with this taxonomy classification.
Where in Oregon is BRENDAN CARGILL CARROLL (MD) registered?
Use Portland, Oregon as the headline location for BRENDAN CARGILL CARROLL (MD) here.
What does 2 location(s) imply?
2 practice locations appear in the available data.

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