Individual provider Active NPI

Christopher Carlson

  • Physician Assistant
  • Rochester, NY
National Provider Identifier
1124411269
Registry record updated May 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
018512 Issued in NY
Practice address
601 Elmwood Ave
619-HMD
Rochester, NY 14642-0001
Phone
(585) 275-2100
NPI assigned
Mar 13, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 15, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 18512 NY
Physician Assistant 363A00000X 018512 NY Primary

Addresses

Primary practice location

601 Elmwood Ave
619-HMD
Rochester, NY 14642-0001

Mailing address

30 Baker St Apt 37
Churchville, NY 14428-9803
Phone (718) 687-2139

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address ccarlson94979@direct.urmc.rochester.edu Direct
Direct Messaging Address ccarlson94979@direct.urmc.rochester.edu Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170202000925 NY Practitioner - Physician Assistant 0143519561 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
99.12 of 100Reported as group
Quality
66.85
Promoting interoperability
100
Improvement activities
40
Cost
96.87

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
18512NYMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Hematology Clinical Group Current Accepting new patients
Internal Medicine Group CurrentSince Jan 1, 2017 Accepting new patients
Nicholas H. Noyes Memorial Hospital CurrentSince Mar 12, 2018 Accepting new patients

Locations

73 Buffalo St
Ste 100
Canandaigua, NY 14424

111 Clara Barton St
Dansville, NY 14437
Phone (585) 335-3100

601 Elmwood Ave
#619
Rochester, NY 14642
Phone (585) 275-3516

601 Elmwood Ave
Rochester, NY 14642
Phone (585) 275-9555

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1426204800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684108800000",
    "number": "1124411269",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 BAKER ST APT 37",
            "city": "CHURCHVILLE",
            "state": "NY",
            "postal_code": "144289803",
            "telephone_number": "718-687-2139"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 ELMWOOD AVE",
            "address_2": "619-HMD",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146420001",
            "telephone_number": "585-275-2100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARLSON",
        "first_name": "CHRISTOPHER",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-03-13",
        "last_updated": "2023-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "18512",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "018512",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ccarlson94979@direct.urmc.rochester.edu",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "OTHER",
            "address_1": "601 Elmwood Ave",
            "city": "Rochester",
            "state": "NY",
            "country_code": "US",
            "postal_code": "146420001",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ccarlson94979@direct.urmc.rochester.edu",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "OTHER",
            "address_1": "601 Elmwood Ave",
            "city": "Rochester",
            "state": "NY",
            "country_code": "US",
            "postal_code": "146420001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Rochester, NY

Sources for this page

Verify at the official NPI Registry.