Individual provider Active NPI

Thomas Michael Carlson, MSN, CRNA

  • Certified Registered Nurse Anesthetist
  • Newark, DE
National Provider Identifier
1003656687
Registry record updated May 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
152303 Issued in DE
Practice address
4755 Ogletown Stanton Rd
Newark, DE 19718-2200
Phone
(302) 733-1000
NPI assigned
May 30, 2024
Last updated
May 30, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 30, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 152303 DE Primary

Addresses

Primary practice location

4755 Ogletown Stanton Rd
Newark, DE 19718-2200

Mailing address

100 W Commons Blvd Ste 400
New Castle, DE 19720-2419
Phone (302) 709-4709

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DE, PA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20241120003257 DE Practitioner - Certified Registered Nurse Anesthetist (Crna) 8921533415 Reassigns benefits to 1 organization
I20241206001025 PA Practitioner - Certified Registered Nurse Anesthetist (Crna) 8921533415 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Drexel University College of Medicine, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Anesthesia Services PAGroup PAC ID 9537064498, 201 clinicians

Practice addresses (Care Compare)

100 Wilmington W Chester Pike
Suite 100
Chadds Ford, PA 19317-9040
Phone (610) 672-4900

4755 Ogletown Stanton Rd
Newark, DE 19718-2200
Phone (302) 733-1000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing

State licenses

LicenseStateTypeSpecialty
152303DEMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Anesthesia Services PA CurrentSince Aug 23, 2024 Accepting new patients
Chadds Ford Ambulatory Surgical Center, LLC CurrentSince Oct 3, 2024 Accepting new patients

Locations

2600 Glasgow Ave
Ste 226
Newark, DE 19702
Phone (302) 836-3539

4755 Ogletown Stanton Rd
Newark, DE 19718
Phone (302) 733-1700

100 Wilmington W Chester Pike
Ste 100
Chadds Ford, PA 19317
Phone (610) 672-4900

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1717027200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717027200000",
    "number": "1003656687",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 W COMMONS BLVD STE 400",
            "city": "NEW CASTLE",
            "state": "DE",
            "postal_code": "197202419",
            "telephone_number": "302-709-4709"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4755 OGLETOWN STANTON RD",
            "city": "NEWARK",
            "state": "DE",
            "postal_code": "197182200",
            "telephone_number": "302-733-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARLSON",
        "first_name": "THOMAS",
        "middle_name": "MICHAEL",
        "name_prefix": "Mr.",
        "credential": "MSN, CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-05-30",
        "last_updated": "2024-05-30",
        "certification_date": "2024-05-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "DE",
            "license": "152303",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newark, DE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.