Adam Michael Carlson, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

4901004537 Issued in MI

Practice address

55 Campau Ave NW
Ste 10
Grand Rapids, MI 49503-2642

Phone

(616) 459-7380

Fax

(616) 459-5752

NPI assigned

Sep 30, 2009

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Optometry

Education

Ferris State College - College of Optometry, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Carlson Eye Care, LLCGroup PAC ID 5597157891, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Carlson Eye Care, LLC

  • Optometrist
  • Grand Rapids, MI
  • NPI 1215605134
  Medicare reassignment Care Compare group NPD Authorized official
• Cherry Street Services, Inc.

  • Federally Qualified Health Center (FQHC)
  • Grand Rapids, MI
  • NPI 1558459164
  Medicare reassignment NPD
• Cherry Street Services, Inc

  • Federally Qualified Health Center (FQHC)
  • Howard City, MI
  • NPI 1831955251
  NPD

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

{
    "created_epoch": "1254268800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641945600000",
    "number": "1124352687",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 CAMPAU AVE NW",
            "address_2": "STE 10",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495032642",
            "telephone_number": "616-459-7380",
            "fax_number": "616-459-5752"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 CAMPAU AVE NW",
            "address_2": "STE 10",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495032642",
            "telephone_number": "616-459-7380",
            "fax_number": "616-459-5752"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARLSON",
        "first_name": "ADAM",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-09-30",
        "last_updated": "2022-01-12",
        "certification_date": "2022-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MI",
            "license": "4901004537",
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IN",
            "license": "18003669A",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carla Miller Ma MSW
• Catherine Carle, MD
• Sarah Dixcy Carlisle, P.A.
• Carlson Eye Care, LLC
• Connor Jalaine Carlson-Yderstad, LLMSW
• Allison Amanda Carlson
• Anna Rose Carlson
• Delaney Bree Carlson
• Elizabeth M Carlson, PA-C
• Kelsey Michelle Carlson

• Optometrist in Grand Rapids, MI
• Providers in Grand Rapids, MI by specialty
• Optometrist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2022; 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.

Verify at the official NPI Registry.