Active NPI
Gregory Carlson, M.D.
- Vascular Surgery Physician
- Colorado Springs, CO
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Vascular Surgery Physician
- License
- DR.0042262
- Practice address
- 1400 E Boulder St
Suite 600
Colorado Springs, CO 80909-5533 - Phone
- (719) 365-6487
- Fax
- (719) 364-6488
- NPI assigned
- Dec 30, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician | 208600000X | DR.0042262 | CO | |
| Vascular Surgery Physician | 2086S0129X | DR.0042262 | CO | Primary |
Addresses
Primary practice location
1400 E Boulder St
Suite 600
Colorado Springs, CO 80909-5533
Mailing address
1400 E Boulder St
Suite 600
Colorado Springs, CO 80909-5533
Phone (719) 365-6487
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 46032240 | Medicaid | CO |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CO
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20040806000436 | CO | Practitioner - Vascular Surgery | 6709858251 | Reassigns benefits to 2 organizations |
Care Compare profile
Medicare Care Compare- Specialty
- Vascular Surgery
- Education
- Jefferson Medical College of Thomas Jefferson University, 1997
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Poudre Valley Medical Group LLC
Practice addresses (Care Compare)
4110 Briargate Pkwy
Colorado Springs, CO 80920-7835
Phone (719) 364-8346
Hospital & facility affiliations
- Uch-Memorial Health System
- Rio Grande Hospital
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Leg revascularization (restoring blood flow) | 1-10 |
| Removal of tissue | 80 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DR.0042262 | CO | MD | Surgery Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Uchealth Imaging Services, LLC | Current | Accepting new patients | |
| Uchealth Imaging Services, LLC | Current | Accepting new patients | |
| Poudre Valley Medical Group, LLC | Current | Accepting new patients | |
| Poudre Valley Medical Group, LLC | Surgery | Current | Accepting new patients |
| Uchealth Imaging Services LLC | Current | Accepting new patients | |
| Memorial Health System | Surgery | Past | Accepting new patients |
| Uch-MHS | Past | Accepting new patients |
Locations
875 W 136th Ave
Ste 100
Broomfield, CO 80023
Phone (303) 457-7700
4404 Barranca Ln
Castle Rock, CO 80104
Phone (720) 733-5260
1400 E Boulder St
Ste 600
Colorado Springs, CO 80909
Phone (719) 364-6487
3843 Rio Vista Dr
Ste 2100
Colorado Springs, CO 80917
Phone (719) 364-5250
4110 Briargate Pkwy
Ste 140
Colorado Springs, CO 80920
Phone (719) 365-7300
8890 N Union Blvd
Colorado Springs, CO 80920
Phone (719) 364-5633
1400 E Boulder St
Colorado Springs, CO 80909
Phone (719) 365-5120
100 Cook St
Ste 410
Denver, CO 80206
Phone (720) 516-9420
2695 Rocky Mountain Ave
Ste 150
Loveland, CO 80538
Phone (970) 624-2412
1401 Court St
Pueblo, CO 81003
Phone (719) 562-2300
Organizations & group practices 7
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
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- Loveland, CO
- NPI 1366763260
-
- Magnetic Resonance Imaging (MRI) Clinic/Center
- Englewood, CO
- NPI 1386208635
-
- Diagnostic Radiology Physician
- Highlands Ranch, CO
- NPI 1043162142
-
- General Acute Care Hospital
- Colorado Springs, CO
- NPI 1144397134
Hospital & facility affiliations 21
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": "1135900800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1581292800000",
"number": "1073590972",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1400 E BOULDER ST",
"address_2": "SUITE 600",
"city": "COLORADO SPRINGS",
"state": "CO",
"postal_code": "809095533",
"telephone_number": "719-365-6487",
"fax_number": "719-364-6488"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1400 E BOULDER ST",
"address_2": "SUITE 600",
"city": "COLORADO SPRINGS",
"state": "CO",
"postal_code": "809095533",
"telephone_number": "719-365-6487",
"fax_number": "719-364-6488"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CARLSON",
"first_name": "GREGORY",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-12-30",
"last_updated": "2020-02-10",
"certification_date": "2020-02-10",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "CO",
"license": "DR.0042262",
"primary": false
},
{
"code": "2086S0129X",
"taxonomy_group": "",
"desc": "Surgery, Vascular Surgery",
"state": "CO",
"license": "DR.0042262",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "46032240",
"state": "CO"
}
],
"endpoints": [],
"other_names": []
}Other providers in Colorado Springs, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- 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.