Individual provider Active NPI

Kurtis David Carlock, MD

  • Adult Reconstructive Orthopaedic Surgery Physician
  • Arlington, VA
National Provider Identifier
1245791458
Registry record updated Aug 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Reconstructive Orthopaedic Surgery PhysicianTaxonomy code 207XS0114X
License
0101284933 Issued in VA
Practice address
1715 North George Mason Dr
Medical Offices D, Suite 504
Arlington, VA 22205
Phone
(703) 525-2200
NPI assigned
Mar 29, 2019
Last updated
Aug 12, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Reconstructive Orthopaedic Surgery Physician 207XS0114X 0101284933 VA Primary

Addresses

Primary practice location

1715 North George Mason Dr
Medical Offices D, Suite 504
Arlington, VA 22205

Mailing address

1715 North George Mason Drive
Medical Offices D, Suite 504
Arlington, VA 22205
Phone (703) 525-2200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN, IL, DC3 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 3

Enrollment IDStateProvider typePAC IDDetails
I20240411000233 IN Practitioner - Orthopedic Surgery 6406189646 Reassigns benefits to 1 organization
I20240529000577 IL Practitioner - Orthopedic Surgery 6406189646 Reassigns benefits to 1 organization
I20250922002392 DC Practitioner - Orthopedic Surgery 6406189646 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
New York University School of Medicine, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1715 N George Mason Dr
Suite 504
Arlington, VA 22205-3670
Phone (703) 525-2200

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hip replacement16
Knee replacement18

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0101284933VAMDAdult Reconstructive Orthopaedic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Orthomidwest, PLLC CurrentSince Apr 4, 2024 Accepting new patients
Nirschl Orthopaedic Center for Sportsmedicine & Joint Reconstruction Orthopaedic Surgery CurrentSince Aug 1, 2025 Accepting new patients
Orthomidwest, PLLC Orthopaedic Surgery CurrentSince Jun 1, 2024 Accepting new patients
Orthomidwest, PLLC Orthopaedic Surgery CurrentSince Apr 4, 2024 Accepting new patients

Locations

770 Beloit Rd
Belvidere, IL 61008
Phone (815) 847-7060

1611 W Harrison St
Ste 400
Chicago, IL 60612
Phone (312) 243-4244

9200 Calumet Ave
Ste 300
Munster, IN 46321
Phone (708) 236-2737

9601 Calumet Ave
Munster, IN 46321
Phone (312) 432-2591

1715 N George Mason Dr
Ste 504
Arlington, VA 22205
Phone (703) 525-2200

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.

Hospital & facility affiliations 3

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": "1553817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754956800000",
    "number": "1245791458",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1715 NORTH GEORGE MASON DRIVE",
            "address_2": "MEDICAL OFFICES D, SUITE 504",
            "city": "ARLINGTON",
            "state": "VA",
            "postal_code": "22205",
            "telephone_number": "703-525-2200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1715 NORTH GEORGE MASON DR",
            "address_2": "MEDICAL OFFICES D, SUITE 504",
            "city": "ARLINGTON",
            "state": "VA",
            "postal_code": "22205",
            "telephone_number": "703-525-2200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARLOCK",
        "first_name": "KURTIS",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-03-29",
        "last_updated": "2025-08-12",
        "certification_date": "2025-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207XS0114X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery",
            "state": "VA",
            "license": "0101284933",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Arlington, VA

Sources for this page

Verify at the official NPI Registry.