NPIMap

Individual provider Active NPI

Justin Carlson, MD

  • Hospitalist Physician
  • Silverdale, WA
National Provider Identifier
1477040939
Registry record updated Jan 26, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
MD61099883 Issued in WA
Practice address
1800 NW Myhre Rd
Silverdale, WA 98383-7663
Phone
(480) 886-5499
NPI assigned
Apr 19, 2018
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 26, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hospitalist Physician 208M00000X MD61099883 WA Primary

Addresses

Primary practice location

1800 NW Myhre Rd
Silverdale, WA 98383-7663

Mailing address

1800 NW Myhre Rd
Silverdale, WA 98383-7663

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL www.theabfm.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA, ID2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20210817001375 WA Practitioner - Family Practice 2668716507 Reassigns benefits to 1 organization
I20240119003497 ID Practitioner - Family Practice 2668716507 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
South Sound Inpatient Physicians PLLC 424 clinicians
Sound Physicians of Idaho 47 clinicians

Practice addresses (Care Compare)

2520 Cherry Ave
Bremerton, WA 98310-4229
Phone (360) 377-3911

407 14TH Ave SE
Puyallup, WA 98372-3770
Phone (253) 697-4000

4300 E Flamingo Ave
Nampa, ID 83687-3138
Phone (208) 205-1000

Hospital & facility affiliations

  • St Michael Medical Center Hospital, Silverdale, WA, CCN 500039
  • St Joseph Regional Medical Center Hospital, Lewiston, ID, CCN 130003
  • Jefferson Healthcare Hospital, Port Townsend, WA, CCN 501323
  • Olympic Medical Center Hospital, Port Angeles, WA, CCN 500072
  • Tri-State Memorial Hospital Hospital, Clarkston, WA, CCN 501332

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD61099883WAMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
South Sound Inpatient Physicians PLLC Hospitalist CurrentSince Jul 1, 2021 Accepting new patients
Cogent Healthcare of Washington, PC Hospitalist CurrentSince Oct 15, 2022 Accepting new patients
South Sound Inpatient Physicians PLLC Hospitalist CurrentSince Jul 1, 2021 Accepting new patients
Sound Physicians of Idaho Hospitalist CurrentSince Dec 21, 2023 Accepting new patients
St. Joseph Hospital LLC Past Accepting new patients

Locations

415 6th St
Lewiston, ID 83501
Phone (208) 750-7445

1512 12th Ave Rd
Nampa, ID 83686
Phone (208) 463-5000

4300 E Flamingo Ave
Nampa, ID 83687
Phone (208) 205-1000

120 Brentwood Commons Way
Ste 510
Brentwood, TN 37027
Phone (253) 682-6040

2520 Cherry Ave
Bremerton, WA 98310
Phone (360) 377-3911

407 14th Ave SE
Puyallup, WA 98372
Phone (253) 697-4000

2000 Hospital Dr
Sedro Woolley, WA 98284
Phone (360) 856-6021

1800 NW Myhre Rd
Silverdale, WA 98383
Phone (360) 337-8800

Interoperability endpoints

  • Direct secure messaging: jcarlson285057@fhsce.catholichealth.net
  • Direct secure messaging: jcarlson3113333@direct.trinity-health.org

Organizations & group practices 5

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.

Hospital & facility affiliations 9

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": "1524096000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643155200000",
    "number": "1477040939",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1800 NW MYHRE RD",
            "city": "SILVERDALE",
            "state": "WA",
            "postal_code": "983837663"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 NW MYHRE RD",
            "city": "SILVERDALE",
            "state": "WA",
            "postal_code": "983837663",
            "telephone_number": "480-886-5499"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARLSON",
        "first_name": "JUSTIN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-04-19",
        "last_updated": "2022-01-26",
        "certification_date": "2022-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "WA",
            "license": "MD61099883",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "www.theabfm.org",
            "affiliation": "N",
            "address_1": "1800 NW Myhre Rd",
            "city": "Silverdale",
            "state": "WA",
            "country_code": "US",
            "postal_code": "983837663",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Silverdale, WA

Sources for this page

Verify at the official NPI Registry.