NPIMap

Individual provider Active NPI

Alexandra Anne Carlson, MD

  • Family Medicine Physician
  • Middletown, CT
National Provider Identifier
1063900983
Registry record updated Jun 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
70668 Issued in CT
Practice address
28 Crescent St
Middletown, CT 06457-3650
Phone
(860) 358-4798
NPI assigned
Apr 26, 2018
Last updated
Jun 21, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 70668 CT Primary

Addresses

Primary practice location

28 Crescent St
Middletown, CT 06457-3650

Mailing address

90 S Main St
Middletown, CT 06457-3649
Phone (860) 358-6486

Other practice location 1

90 S Main St
Middletown, CT 06457-3649
Phone (860) 358-6486

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
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
I20220706003018 CT Practitioner - Family Practice 6406103746 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Connecticut School of Medicine, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Middlesex HospitalGroup PAC ID 5092611731, shared by 7 NPIs, 231 clinicians
MHS Primary Care, Inc.Group PAC ID 4082507371, 180 clinicians

Practice addresses (Care Compare)

13 High St
Portland, CT 06480-1616
Phone (860) 358-6486

28 Crescent St
Middletown, CT 06457-3654
Phone (860) 358-5322

520 Saybrook Rd
N100
Middletown, CT 06457-4700
Phone (860) 358-2850

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Middlesex Hospital Family Medicine CurrentSince Jul 1, 2022 Accepting new patients
MHS Primary Care, Inc Family Medicine CurrentSince Aug 15, 2022 Accepting new patients
Connecticut Pathology Group PC Current Accepting new patients
MHS Primary Care Inc Family Medicine CurrentSince Aug 15, 2022 Accepting new patients
Middlesex Hospital Current Accepting new patients
Middlesex Hospital Current Accepting new patients
Middlesex Hospital Family Medicine CurrentSince Nov 29, 2024 Accepting new patients
Middlesex Hospital Family Medicine CurrentSince Jul 1, 2022 Accepting new patients

Locations

28 Crescent St
Middletown, CT 06457
Phone (860) 358-6000

520 Saybrook Rd
Ste N100
Middletown, CT 06457
Phone (860) 344-1801

80 S Main St
Ste 102
Middletown, CT 06457
Phone (860) 358-6878

90 S Main St
Middletown, CT 06457
Phone (860) 358-6300

13 High St
Portland, CT 06480
Phone (860) 358-6418

270 Main St
Ste A
Portland, CT 06480
Phone (860) 358-5040

Organizations & group practices 8

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 2

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": "1524700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655769600000",
    "number": "1063900983",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "90 S MAIN ST",
            "city": "MIDDLETOWN",
            "state": "CT",
            "postal_code": "064573649",
            "telephone_number": "860-358-6486"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28 CRESCENT ST",
            "city": "MIDDLETOWN",
            "state": "CT",
            "postal_code": "064573650",
            "telephone_number": "860-358-4798"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "90 S Main St",
            "address_purpose": "LOCATION",
            "city": "Middletown",
            "state": "CT",
            "postal_code": "064573649",
            "country_code": "US",
            "telephone_number": "860-358-6486",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CARLSON",
        "first_name": "ALEXANDRA",
        "middle_name": "ANNE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-04-26",
        "last_updated": "2022-06-21",
        "certification_date": "2022-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CT",
            "license": "70668",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Middletown, CT

Sources for this page

Verify at the official NPI Registry.