Dr. James Carroll , MD
Surgery • Worcester, MA
55 Lake Ave N, Department Of Surgery
Worcester, MA 016550002
This profile restates public CMS/NPPES data; T-MedInfo gives no medical advice — consult a licensed professional, and call 911 for emergencies.
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NPI assigned on January 10, 2007; this date does not establish years in practice.
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Published CMS data list 222 Original Medicare Part B services in 2024.
Source: CMS, Medicare Physician & Other Practitioners – by Provider and Service, 2024. Published rows only; this is not a quality measure.
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Published Part B service records, 2024:
- 99213 — Established patient outpatient office visit: 60 service units.
- 99203 — New patient outpatient office visit: 57 service units.
- 99222 — Initial hospital care with straightforward or low-level medical decision making: 40 service units.
Source: CMS, Medicare Physician & Other Practitioners – by Provider and Service, 2024. Units differ by code; these are not visits or a measure of quality.
CPT® only copyright 2023 American Medical Association. All rights reserved. Service names are shortened from CPT Consumer Friendly Descriptors (CMS data, 2024). CPT notice
See all 7 records in the table · Guide: How to read Medicare Part B data
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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 Medicare Part B services among clinicians listed under Surgery in Massachusetts (2024, 438 clinicians with data). Median for this group: 221. Middle half: 112 to 421.
Source: CMS, Medicare Physician & Other Practitioners – by Provider and Service, 2024. Billing and prescribing volume is not a quality rating.
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Medicare Part B services went from 232 in 2020 to 222 in 2024.
Source: CMS, Medicare Physician & Other Practitioners – by Provider and Service, 2020–2024.
Practice Location & Contact Primary Location
55 Lake Ave N
Department Of Surgery
Worcester, MA 016550002
Matched by practice address or phone in NPPES. A shared address or phone does not confirm that this clinician works there.
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
Warren Alpert Medical School Of Brown University
2006
What Public CMS Data Show
Surgery: NPPES taxonomy is a reported classification, not proof of board certification.
Medicare patients
198 people with Original Medicare in 2024
It gives a sense of how many people with Medicare this clinician treated that year.
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.
It shows the total cost of this clinician's Original Medicare services under Medicare's fee rules.
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.
The gap between the allowed amount and this number is roughly what patients and their other insurance paid.
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.
Source: Calculated by T-MedInfo from CMS Open Payments general-payment records for program year 2024 (published June 30, 2026).
Years since graduation
20 years (graduated 2006)
CMS Doctors and Clinicians data list 2006 as the year this clinician finished professional school.
It tells you roughly how long ago the clinician finished 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.
With Original Medicare, you usually pay only your deductible and coinsurance, and the office sends the claim to Medicare for you.
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?”
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.
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.
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.
Medicare pays for these items and services only when they are ordered by an eligible clinician.
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.
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.
CMS data by year
Changes may reflect reporting, coverage or privacy limits, not changes in care quality.
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Medicare Part B services
Medicare Part B services varied from year to year: 232 in 2020 and 222 in 2024.
- 2020: 232
- 2021: 203
- 2022: 178
- 2023: 240
- 2024: 222
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Medicare-allowed amount
Medicare-allowed amount increased 46% from $21,349 in 2020 to $31,230 in 2024.
- 2020: $21,349
- 2021: $18,933
- 2022: $15,908
- 2023: $26,520
- 2024: $31,230
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Paid by Medicare
Paid by Medicare increased 51% from $16,092 in 2020 to $24,287 in 2024.
- 2020: $16,092
- 2021: $14,569
- 2022: $12,086
- 2023: $19,945
- 2024: $24,287
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Industry payments (Open Payments)
Industry payments (Open Payments) decreased 98% from $7,500.00 in 2022 to $172.90 in 2024.
- 2022: $7,500.00
- 2023: $326.93
- 2024: $172.90
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
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
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XARELTO | General | $89.41 |
| INTUITIVE SURGICAL, INC. |
Food and Beverage
In-kind items and services
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Da Vinci Surgical System | General | $83.49 |
Source: CMS Open Payments, program year 2024, released June 30, 2026.
Performed Procedures & Service Volume
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 |
|---|---|---|---|---|
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99213
Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more
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60 | 50 | $300.00 | $64.35 |
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99203
New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more
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57 | 57 | $358.84 | $79.56 |
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99222
Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes
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40 | 37 | $450.00 | $129.18 |
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99232
Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes
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26 | 16 | $238.00 | $77.69 |
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47562
Removal of gallbladder using an endoscope
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13 | 13 | $3138.00 | $658.92 |
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49650
Repair of groin hernia using an endoscope
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13 | 13 | $1956.77 | $448.38 |
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99214
Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more
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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: 2020-11-02NUCC Taxonomy Code: 208600000X
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.
Additional State Medicaid & Healthcare Payer Identifiers
Medicare (PECOS) Enrollment & Ordering Eligibility
Source: CMS PECOSPRACTITIONER - GENERAL SURGERY
I20130828000426
MA
3678716362
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.
Surgery
Surgery
Doctor of Medicine (M.D.)
Surgery
Doctor of Medicine (M.D.)
Nurse Practitioner
Nurse Practitioner
Surgery
Doctor of Medicine (M.D.)
Surgery
Doctor of Medicine (M.D.)
Career & Practice History Timeline
Changes recorded in monthly NPPES data files: addresses, names, credentials, specialties and NPI status
NPI status registered as active in NPPES database
Registered at 55 LAKE AVE N, DEPARTMENT OF SURGERY, WORCESTER, MA 016550002 (Tel: 5083340545)
Registered at PO BOX 415348, BOSTON, MA 022415348 (Tel: 8002258885)
Recorded as JAMES CARROLL, M.D.
Surgery (license number reported to NPPES: MA 238407)
NPI status registered as active in NPPES database
Registered at 55 LAKE AVE N, DEPARTMENT OF SURGERY, WORCESTER, MA 016550002 (Tel: 5083340545)
Registered at PO BOX 415348, BOSTON, MA 022415348 (Tel: 8002258885)
Recorded as JAMES CARROLL, M.D.
Surgery (license number reported to NPPES: MA 238407)
First registered as active Individual Practitioner in NPPES Database.
NPI Administrative Meta
Other Surgery Specialists in Worcester
- Dr. Gil Freitas, MD
- Dr. Mark Stoker, MD
- Dr. Michael Potter, MD
- Dr. Charles Fang, MD
- Dr. Erica Sneider, MD
- Dr. Catharine Crawford, MD
Mailing Address
Po Box 415348
Boston, MA 022415348
Phone: 8002258885