Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Nicole Carrillo

Individual provider Emergency Medicine Physician · NPI 1942695796

Nicole Carrillo is an Emergency Medicine in Fort Worth, Texas. Graduated from Arizona College of Osteopathic Medicine Mid Western University in 2015, 11 years ago. Practices with Century Integrated Partners, Inc, a 330-clinician group and accepts Medicare assignment. Licensed in Texas.

Years since qualifying
11
Trained at
Arizona College of Osteopathic Medicine Mid Western University
Licensed in
TX
In the registry since
2015
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Practice location Address checks out

1500 S Main St
Fort Worth, TX 76104-4917
Phone: (817) 702-3431
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Emergency Medicine Physician (primary) Taxonomy 207P00000X · Licence R4460 (TX)

Record details

NPI number1942695796
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedMarch 30, 2015
Last updated in NPPESMarch 6, 2025
Certification dateMarch 6, 2025
Mailing address1500 S Main St, Fort Worth, TX 76104-4917

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyEMERGENCY MEDICINE
Medical schoolARIZONA COLLEGE OF OSTEOPATHIC MEDICINE MID WESTERN UNIVERSITY
Graduated 2015 (11 years in practice)
Group practice Century Integrated Partners, Inc — 330 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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