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Dr. James Carroll , MD

Surgery • Worcester, MA

Active NPI 1992854681 Individual Practitioner Male Practitioner Accepts Medicare assignment
Practice location in NPPES

55 Lake Ave N, Department Of Surgery
Worcester, MA 016550002

Call 5083340545 Location details and other listings
Medical Disclaimer

This profile restates public CMS/NPPES data; T-MedInfo gives no medical advice — consult a licensed professional, and call 911 for emergencies.

Practice Location & Contact Primary Location

Practice Address

55 Lake Ave N
Department Of Surgery

Worcester, MA 016550002

Telephone 5083340545
Fax 7744430544
Organization at the Same NPPES Address or Phone
Umass Memorial Medical Center Facility NPI 1679574933

Matched by practice address or phone in NPPES. A shared address or phone does not confirm that this clinician works there.

Other Listings in Public Data

CMS Doctors and Clinicians lists 1 group name: Umass Memorial Medical Group Inc. See the list

Source: CMS Doctors and Clinicians National Downloadable File, release date unavailable.

Listings do not confirm current availability, employment or a shared ownership network.

Medicare Profile & Education

Source: CMS Doctors and Clinicians National Downloadable File

Medical School

Warren Alpert Medical School Of Brown University

Graduation Year

2006

Medicare patients

198 people with Original Medicare in 2024

Different Original Medicare patients in 2024; counts below 11 are hidden; this does not show availability or quality.

Source: CMS, Medicare Physician & Other Practitioners – by Provider, 2024.

Medicare-allowed amount

About $31,230 in 2024

The total amount Medicare approved for these services in 2024. It includes what Medicare paid and what patients or their other insurance owed, such as the deductible and coinsurance.

What this does not show: Medicare-allowed amount

This is not the clinician's income. Part of it can go to a clinic or group practice, staff, equipment or drugs. It is not the price you will pay.

Source: CMS, Medicare Physician & Other Practitioners – by Provider and Service, 2024.

Paid by Medicare

About $24,287 in 2024

The part of the Medicare-allowed amount that Medicare itself paid in 2024, after patients' deductibles and coinsurance.

What this does not show: Paid by Medicare

This is not the clinician's income and not a measure of quality.

Source: CMS, Medicare Physician & Other Practitioners – by Provider and Service, 2024.

Open Payments general payments, program year 2024

All general payments: $172.90 across 2 records.

By nature of payment

  • Food and Beverage: $172.90 across 2 records.

Reporting-company totals

  • Janssen Pharmaceuticals, Inc: $89.41 across 1 record.
  • INTUITIVE SURGICAL, INC.: $83.49 across 1 record.

A reported payment does not necessarily mean the financial relationship is improper and is not a measure of care quality. Clinicians can review and dispute these records.

See the full table

Source: Calculated by T-MedInfo from CMS Open Payments general-payment records for program year 2024 (published June 30, 2026).

Guide: How to read an Open Payments record

Years since graduation

20 years (graduated 2006)

CMS Doctors and Clinicians data list 2006 as the year this clinician finished professional school.

What this does not show: Years since graduation

It is not the number of years in practice, and more years does not mean better care.

Source: CMS Doctors and Clinicians National Downloadable File.

NPI first issued

2007

The year this clinician's National Provider Identifier (NPI) was issued. An NPI is a unique 10-digit ID that US health care providers use for billing.

What this does not show: NPI first issued

NPIs have been issued only since 2005, so this year is not necessarily when the clinician started practicing.

Source: CMS NPPES NPI Registry.

Accepts Medicare assignment

CMS data list this clinician as accepting Medicare assignment. This means agreeing to take the Medicare-approved amount as full payment for covered services.

Medicare assignment applies to Original Medicare. It does not tell you whether the clinician is in a Medicare Advantage plan's network, accepts other insurance, or is taking new patients.

Source: CMS Doctors and Clinicians; Medicare.gov, “Does your provider accept Medicare as full payment?”

Guide: What Medicare assignment means

No telehealth indicator

CMS shows this indicator only when recent Medicare claims include telehealth services. The clinician may still offer telehealth; ask the office.

Source: CMS, Telehealth Indicator on Medicare Care Compare (fact sheet, January 2023); CMS Doctors and Clinicians.

Guide: How Medicare covers telehealth

Enrolled in Medicare (PECOS)

Dr. Carroll has a Medicare enrollment record in PECOS, the CMS system clinicians use to enroll so they can bill Medicare or order services for people with Medicare.

It does not show whether the clinician accepts assignment, is in your plan's network, or is taking new patients.

Source: CMS Medicare Fee-For-Service Public Provider Enrollment (PECOS); CMS Order and Referring file.

Guide: What Medicare enrollment (PECOS) means

Can order Medicare-covered services

CMS lists Dr. Carroll as eligible to order or refer Medicare Part B clinical laboratory and imaging services, durable medical equipment (DME) and home health services for people with Medicare.

What this does not show: Can order Medicare-covered services

It does not mean the clinician offers these services directly.

Source: CMS Medicare Fee-For-Service Public Provider Enrollment (PECOS); CMS Order and Referring file.

Guide: What ordering and referring status means

Compared with the same specialty in Worcester and Massachusetts

Billing and prescribing volume is not a quality rating.

Medicare Part B services

More Medicare Part B services than 75% of clinicians listed under Surgery in Worcester, MA (2024, 22 clinicians with data). Median for this group: 157. Middle half: 94 to 221.

Close to the middle for clinicians listed under Surgery in Massachusetts (2024, 438 clinicians with data). Median for this group: 221. Middle half: 112 to 421.

Medicare-allowed amount

A higher Medicare-allowed amount than 75% of clinicians listed under Surgery in Worcester, MA (2024, 22 clinicians with data). Median for this group: $20,171. Middle half: $9,916 to $30,935.

Close to the middle for clinicians listed under Surgery in Massachusetts (2024, 438 clinicians with data). Median for this group: $32,226. Middle half: $14,398 to $58,427.

Paid by Medicare

A higher Medicare payment amount than 75% of clinicians listed under Surgery in Worcester, MA (2024, 22 clinicians with data). Median for this group: $15,281. Middle half: $7,579 to $23,925.

Close to the middle for clinicians listed under Surgery in Massachusetts (2024, 438 clinicians with data). Median for this group: $24,707. Middle half: $10,899 to $44,507.

45 active clinicians are listed under Surgery with a practice address in Worcester, MA (1,003 in Massachusetts).

Addresses are self-reported to NPPES and may be out of date.

Telehealth indicator in Worcester

22.2% of these 45 clinicians have the CMS telehealth indicator.

57.8% of these 45 clinicians are listed by CMS as accepting Medicare assignment.

Sources: CMS Medicare Physician & Other Practitioners (2024), CMS Open Payments (2024), CMS Doctors and Clinicians, CMS NPPES NPI Registry. Specialty names follow the NUCC Health Care Provider Taxonomy.

Text: T-MedInfo · Report an error.

Pharma & Medical Device Financial Disclosures

Payments and other transfers of value that drug and medical device companies reported to CMS Open Payments

Open Payments · Program Year 2024
Disclosure Year:

Program year 2024 (payments made January 1 – December 31, 2024): fewer than 11 records totaling $172.90.

Manufacturer Payment Nature Product Type Amount ($)
Janssen Pharmaceuticals, Inc
Food and Beverage
In-kind items and services
XARELTO General $89.41
INTUITIVE SURGICAL, INC.
Food and Beverage
In-kind items and services
Da Vinci Surgical System General $83.49

Source: CMS Open Payments, program year 2024, released June 30, 2026.

Performed Procedures & Service Volume

Services billed to Original Medicare Part B in 2024.

CMS Part B · Data Year 2024
Reporting Year:

CPT® is a registered trademark of the American Medical Association. CPT codes, descriptions and other data only are copyright 2016–2023 American Medical Association. All rights reserved. Applicable FARS/HHSARS apply. Descriptions of CPT codes are the AMA's CPT Consumer Friendly Descriptors as published by CMS in the Medicare Physician & Other Practitioners – by Provider and Service data, 2017–2024; they are plain-language summaries, not for clinical coding or documentation. HCPCS Level II codes and descriptions are from CMS. Fee schedules, relative value units, conversion factors and/or related components are not assigned by the AMA, are not part of CPT, and the AMA is not recommending their use. The AMA does not directly or indirectly practice medicine or dispense medical services. The AMA assumes no liability for data contained or not contained herein.

HCPCS Code Services Patients Submitted Charge Medicare Allowed
99213 Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more
60 50 $300.00 $64.35
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more
57 57 $358.84 $79.56
99222 Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes
40 37 $450.00 $129.18
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes
26 16 $238.00 $77.69
47562 Removal of gallbladder using an endoscope
13 13 $3138.00 $658.92
49650 Repair of groin hernia using an endoscope
13 13 $1956.77 $448.38
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more
13 13 $445.00 $96.33

Source: CMS Part B by Provider and Service, 2024; services under 11 beneficiaries omitted by CMS. Privacy limits

Submitted charges are billed amounts, not a price quote for your visit.

Specialties & License Numbers Reported to NPPES

Self-certified to NPPES: 2020-11-02
Surgery Primary Specialty

NUCC Taxonomy Code: 208600000X

License # reported to NPPES MA 238407

A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery.

Check License Status with the State Board License numbers are self-reported to NPPES; T-MedInfo does not confirm them against state records. Current status: Massachusetts Board of Registration in Medicine.
Look Up on State Board Site

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid ID
110095660A (MA)

Medicare (PECOS) Enrollment & Ordering Eligibility

Source: CMS PECOS
Medicare FFS Enrollment Status Medicare Enrollment on File
CMS Provider Specialty

PRACTITIONER - GENERAL SURGERY

Medicare Enrollment ID

I20130828000426

Enrollment State Jurisdiction

MA

PECOS Control ID

3678716362

Medicare Order & Referring Eligibility
Clinical Lab & Imaging (Part B) Eligible
Durable Medical Equipment (DME) Eligible
Home Health Agency (HHA) Eligible
Power Mobility Devices (PMD) Eligible

Sources: CMS Provider Enrollment and Order and Referring. Medicare enrollment is a billing status, not an accreditation or quality rating.

Medicare Group Practice Enrollments

Source: CMS Doctors and Clinicians National Downloadable File

Umass Memorial Medical Group Inc

155 Union St, Marlborough, MA 017521228

Phone: 5084817390

Umass Memorial Medical Group Inc

119 Belmont St, Worcester, MA 016052903

Phone: 5083341000

Umass Memorial Medical Group Inc

55 Lake Ave N, Worcester, MA 016550002

Phone: 5083341000

Umass Memorial Medical Group Inc

157 Union St, Marlborough, MA 017521228

Phone: 5084865521

Umass Memorial Medical Group Inc

281 Lincoln St, Worcester, MA 016052138

Phone: 5083341000

Clinicians Sharing This Practice Address or Phone

Clinicians sharing this NPPES address, phone or fax; a shared contact does not mean they work together.

9 listed
NPI 1528645561
NPI 1366860892

Doctor of Medicine (M.D.)

NPI 1922268275

Doctor of Medicine (M.D.)

Terese Holm , NP

Nurse Practitioner

NPI 1851911150

Nurse Practitioner

NPI 1235592882

Doctor of Medicine (M.D.)

NPI 1356325062

Doctor of Medicine (M.D.)

Career & Practice History Timeline

Changes recorded in monthly NPPES data files: addresses, names, credentials, specialties and NPI status

11 Historical Events
✅
NPI Profile Active April 24, 2017

NPI status registered as active in NPPES database

📍
Updated Practice Location April 24, 2017

Registered at 55 LAKE AVE N, DEPARTMENT OF SURGERY, WORCESTER, MA 016550002 (Tel: 5083340545)

📍
Updated Business Mailing Address April 24, 2017

Registered at PO BOX 415348, BOSTON, MA 022415348 (Tel: 8002258885)

👤
Provider Name / Credentials Updated April 24, 2017

Recorded as JAMES CARROLL, M.D.

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) April 24, 2017

Surgery (license number reported to NPPES: MA 238407)

✅
NPI Profile Active April 19, 2013

NPI status registered as active in NPPES database

📍
Practice Location (Initial Record) April 19, 2013

Registered at 55 LAKE AVE N, DEPARTMENT OF SURGERY, WORCESTER, MA 016550002 (Tel: 5083340545)

📍
Business Mailing Address (Initial Record) April 19, 2013

Registered at PO BOX 415348, BOSTON, MA 022415348 (Tel: 8002258885)

👤
Provider Name / Credentials (Initial Record) April 19, 2013

Recorded as JAMES CARROLL, M.D.

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) April 19, 2013

Surgery (license number reported to NPPES: MA 238407)

🟢
Initial NPI Registration & Enumeration January 10, 2007

First registered as active Individual Practitioner in NPPES Database.

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NPI Administrative Meta

NPI Number: 1992854681
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: January 10, 2007
Last Update: November 02, 2020
Sole Proprietor: No

Other Surgery Specialists in Worcester

All Surgery Specialists in Worcester

Mailing Address

Po Box 415348

Boston, MA 022415348

Phone: 8002258885

About This Data NPPES fields (address, phone, specialty, license) are self-reported and may be outdated; Medicare fields follow the CMS dataset named in each section. Correct directly at NPPES.