Individual provider Active NPI

Jared William Carlson, M.D.

  • Surgery Physician
  • Amherst, NY
National Provider Identifier
1073775284
Registry record updated Sep 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
270656 Issued in NY
Practice address
3925 Sheridan Dr
Amherst, NY 14226-1738
Phone
(716) 250-9999
NPI assigned
Jun 29, 2008
Last updated
Sep 27, 2023By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 27, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 4301092552 MI
Surgery Physician 208600000X 270656 NY Primary

Addresses

Primary practice location

3925 Sheridan Dr
Amherst, NY 14226-1738

Mailing address

3925 Sheridan Dr
Amherst, NY 14226-1738
Phone (716) 250-9999

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GU, NY2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20150226001649 GU Practitioner - General Surgery 4486970050 Reassigns benefits to 1 organization
I20211209002672 NY Practitioner - Hand SurgeryPractitioner - Orthopedic Surgery 4486970050 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Hand SurgeryAlso: Orthopedic Surgery
Education
Wayne State University School of Medicine, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Excelsior Orthopaedics LLPGroup PAC ID 2062491517, 146 clinicians

Practice addresses (Care Compare)

10195 Niagara Falls Blvd
Suite 100
Niagara Falls, NY 14304-2941
Phone (716) 250-9999

260 Red Tail Rd
Orchard Park, NY 14127-1562
Phone (716) 250-9999

3925 Sheridan Dr
Amherst, NY 14226-1738
Phone (716) 250-9999

8750 Transit Rd
East Amherst, NY 14051-2610

Merit-based Incentive Payment System (MIPS)

Final score
89.79 of 100Reported as group
Quality
89.94
Promoting interoperability
88
Improvement activities
40
Cost
82.5

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301092552MIMDSurgery Physician
270656NYMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Excelsior Orthopaedics, LLP CurrentSince Jan 17, 2022 Accepting new patients
Guam Memorial Hospital CurrentSince Dec 19, 2014 Accepting new patients
Excelsior Orthopaedics LLP CurrentSince Jan 17, 2022 Accepting new patients
Guam Memorial Hospital CurrentSince Dec 19, 2014 Accepting new patients

Locations

850 Gov Carlos G Camacho Rd
#R
Tamuning, GU 96913
Phone (671) 647-2552

3925 Sheridan Dr
Buffalo, NY 14226
Phone (716) 250-6500

8750 Transit Rd
Ste 105
East Amherst, NY 14051
Phone (716) 636-1470

10195 Niagara Falls Blvd
#100
Niagara Falls, NY 14304

260 Red Tail Rd
Orchard Park, NY 14127
Phone (716) 675-5711

Interoperability endpoints

  • Direct secure messaging: jcarlson@excelsiorortho.medentdirect.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.

NPI Registry JSON

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

{
    "created_epoch": "1214697600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695772800000",
    "number": "1073775284",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3925 SHERIDAN DR",
            "city": "AMHERST",
            "state": "NY",
            "postal_code": "142261738",
            "telephone_number": "716-250-9999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3925 SHERIDAN DR",
            "city": "AMHERST",
            "state": "NY",
            "postal_code": "142261738",
            "telephone_number": "716-250-9999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARLSON",
        "first_name": "JARED",
        "middle_name": "WILLIAM",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-06-29",
        "last_updated": "2023-09-27",
        "certification_date": "2022-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MI",
            "license": "4301092552",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NY",
            "license": "270656",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Amherst, NY

Sources for this page

Verify at the official NPI Registry.