Carl Jeffrey Carlson, M.D.

Primary specialty

Cardiovascular Disease PhysicianTaxonomy code 207RC0000X

License

G29295 Issued in CA

Practice address

2333 Mowry Ave
Suite 220
Fremont, CA 94538-1700

Phone

(510) 792-2012

Fax

(510) 792-7986

NPI assigned

Jul 12, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in CA

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 1

Specialty

Cardiovascular Disease (Cardiology)Also: Internal Medicine

Education

Tufts University School of Medicine, 1969

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Washington Township Hospital DistrictGroup PAC ID 2860488822, 28 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Washington Hospital Hospital, Fremont, CA, CCN 050195

Merit-based Incentive Payment System (MIPS)

Final score

22.25 of 100Reported as individual

Quality

0

Improvement activities

0

Cost

74.18

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: carl.carlson@fremontheart.directbygreenway.com

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Elizabeth Elin Crowder, PA-C

  • Physician Assistant
  • San Ramon, CA
  • NPI 1508170754

  CA

  Medicare reassignment

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.

• Washington Township Hospital District

  • General Acute Care Hospital
  • Fremont, CA
  • NPI 1154472058

  CA

  Medicare reassignment Care Compare group NPD
• California Cardiovascular Consultants

  • Internal Medicine Physician
  • Fremont, CA
  • NPI 1932202959

  CA, Cardiovascular Disease

  Medicare reassignment NPD
• Ams Mobile Health Diagnostics

  • Vascular Sonography Radiologic Technologist
  • San Mateo, CA
  • NPI 1770001992
  NPD
• California Cardiovascular Consultants Medical Associates

  • Internal Medicine Physician
  • Newark, CA
  • NPI 1538358122
  NPD
• Carl J Carlson MD

  • Cardiovascular Disease Physician
  • Fremont, CA
  • NPI 1508075540

  Cardiovascular Disease

  NPD (past)
• Eden Medical Center/San Leandro Hospital Campus

  • Rehabilitation Hospital Unit
  • San Leandro, CA
  • NPI 1679523633
  NPD (past)
• Hayward Sisters Hospital

  • General Acute Care Hospital
  • Hayward, CA
  • NPI 1942298153
  NPD (past)
• Stanford Hospital and Clinics

  • Clinical Medical Laboratory
  • Palo Alto, CA
  • NPI 1174698468
  NPD (past)
• Upmc Washington

  • Rehabilitation Hospital Unit
  • Washington, PA
  • NPI 1427166602
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Washington Township Hospital District

  • General Acute Care Hospital
  • Fremont, CA
  • NPI 1780614685

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1152662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1300406400000",
    "number": "1386669489",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2333 MOWRY AVE",
            "address_2": "SUITE 220",
            "city": "FREMONT",
            "state": "CA",
            "postal_code": "945381700",
            "telephone_number": "510-792-2012",
            "fax_number": "510-792-7986"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2333 MOWRY AVE",
            "address_2": "SUITE 220",
            "city": "FREMONT",
            "state": "CA",
            "postal_code": "945381700",
            "telephone_number": "510-792-2012",
            "fax_number": "510-792-7986"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARLSON",
        "first_name": "CARL",
        "middle_name": "JEFFREY",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-12",
        "last_updated": "2011-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "CA",
            "license": "G29295",
            "primary": true
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "CA",
            "license": "G29295",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "060006330",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COMMERCIAL",
            "identifier": "A44008",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G292950",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECROSS AND BLUESHIELD",
            "identifier": "00G292950",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Care in Touch Home Health Agency
• Care2U
• Stacey S Cariaso, L.C.S.W.
• Carl J Carlson MD
• Bonnie Lee Carlson
• Joshua Carlson
• Mark Anthony Carlton, LVN
• Jeffrey Alan Carmel, MD
• Allison C Carmichael, M.D.
• Sergio Carmona

• Cardiovascular Disease Physician in Fremont, CA
• Providers in Fremont, CA by specialty
• Cardiovascular Disease Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2011; 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.