NPIMap

Individual provider Active NPI

Carolyn N Erickson, M.D.

  • Internal Medicine Physician
  • Chicago, IL
National Provider Identifier
1043572126
Registry record updated Jun 5, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
036.137804 Issued in IL
Practice address
251 E Huron St
Feinberg 16 738
Chicago, IL 60611-2908
Phone
(312) 926-2000
NPI assigned
Jun 13, 2012
Last updated
Jun 5, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 5, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 125.061228 IL
Internal Medicine Physician 207R00000X 036.137804 IL Primary

Addresses

Primary practice location

251 E Huron St
Feinberg 16 738
Chicago, IL 60611-2908

Mailing address

251 E Huron St
Feinberg 16-738
Chicago, IL 60611-2908
Phone (978) 771-7938

Other names 1

  • Carolyn N Sanderson Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171023002118 NY Practitioner - Internal Medicine 6305167206 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Tufts University School of Medicine, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Memorial Medical Consultation GroupGroup PAC ID 6406755081, 82 clinicians

Practice addresses (Care Compare)

1275 York Ave
New York, NY 10065-6094
Phone (212) 639-2000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75.5 of 100Reported as group
Quality
60.62
Improvement activities
40
Cost
73.87

Merit-based Incentive Payment System (MIPS)

Final score
86.55 of 100Reported as group
Quality
82.52
Improvement activities
40
Cost
72.02

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
036.137804ILMDInternal Medicine Physician
125.061228ILMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Memorial Medical Consultation Group Internal Medicine CurrentSince Jul 31, 2017 Accepting new patients
Memorial Solid Tumor Group Internal Medicine CurrentSince Sep 1, 2017 Accepting new patients
Memorial Developmental Chemo Group CurrentSince Nov 24, 2018 Accepting new patients
Memorial Hospital for Cancer and Allied Diseases Past Accepting new patients

Locations

1275 York Ave
New York, NY 10065
Phone (212) 639-3813

633 3rd Ave
New York, NY 10017

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359

Interoperability endpoints

  • Direct secure messaging: cerickson42257@mskcc.direct-ci.com

Organizations & group practices 4

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 5

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": "1339545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1496620800000",
    "number": "1043572126",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "251 E HURON ST",
            "address_2": "FEINBERG 16-738",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606112908",
            "telephone_number": "978-771-7938"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "251 E HURON ST",
            "address_2": "FEINBERG 16 738",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606112908",
            "telephone_number": "312-926-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ERICKSON",
        "first_name": "CAROLYN",
        "middle_name": "N",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-06-13",
        "last_updated": "2017-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "125.061228",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036.137804",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CAROLYN",
            "last_name": "SANDERSON",
            "middle_name": "N",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.