Active NPI
Robert Carlson, MD
- Medical Oncology Physician
- Philadelphia, PA
National Provider Identifier
1407961535
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Oncology Physician
- License
- MD447356
- Practice address
- 333 Cottman Ave
Philadelphia, PA 19111-2434 - Phone
- (215) 728-2500
- Fax
- (215) 728-3639
- NPI assigned
- Aug 20, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Hematology & Oncology Physician | 207RH0003X | G42022 | CA | |
| Medical Oncology Physician | 207RX0202X | MD447356 | PA | Primary |
Addresses
Primary practice location
333 Cottman Ave
Philadelphia, PA 19111-2434
Mailing address
2450 W Hunting Park Ave
Philadelphia, PA 19129-1302
Phone (215) 728-2500
Other practice location 1
300 Pasteur Dr
Stanford, CA 94305-2200
Phone (650) 498-7103
Other practice location 2
300 Pasteur Dr
Stanford, CA 94305-2200
Phone (650) 498-7103
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00G420220 | Medicaid | CA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD447356 | PA | MD | Medical Oncology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156032000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1522972800000",
"number": "1407961535",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2450 W HUNTING PARK AVE",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191291302",
"telephone_number": "215-728-2500",
"fax_number": "215-728-3639"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "333 COTTMAN AVE",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191112434",
"telephone_number": "215-728-2500",
"fax_number": "215-728-3639"
}
],
"practiceLocations": [
{
"address_1": "300 Pasteur Dr",
"address_purpose": "LOCATION",
"city": "Stanford",
"state": "CA",
"postal_code": "943052200",
"country_code": "US",
"telephone_number": "650-498-7103",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "300 Pasteur Dr",
"address_purpose": "LOCATION",
"city": "Stanford",
"state": "CA",
"postal_code": "943052200",
"country_code": "US",
"telephone_number": "650-498-7103",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "CARLSON",
"first_name": "ROBERT",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-20",
"last_updated": "2018-04-06",
"status": "A"
},
"taxonomies": [
{
"code": "207RH0003X",
"taxonomy_group": "",
"desc": "Internal Medicine, Hematology & Oncology",
"state": "CA",
"license": "G42022",
"primary": false
},
{
"code": "207RX0202X",
"taxonomy_group": "",
"desc": "Internal Medicine, Medical Oncology",
"state": "PA",
"license": "MD447356",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00G420220",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Philadelphia, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.