Kent Steven Carson, M.D.

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

G30260 Issued in CA

Practice address

9460 N Name Uno Ste 210
Gilroy, CA 95020-3532

Phone

(408) 847-0888

Fax

(408) 847-1257

NPI assigned

May 19, 2006

Last updated

Nov 6, 2020By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• Csi Medical Group

  • MOHS-Micrographic Surgery Physician
  • San Pedro, CA
  • NPI 1871909804
  Medicare reassignment
• Leon Lubianker MD Inc

  • Dermatology Physician
  • Gilroy, CA
  • NPI 1417023615
  NPD
• California Skin Institute, a Medical Corporation

  • Dermatology Physician
  • Mountain View, CA
  • NPI 1154527901
  NPD (past)

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

{
    "created_epoch": "1147996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604620800000",
    "number": "1508810292",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9460 N NAME UNO STE 210",
            "city": "GILROY",
            "state": "CA",
            "postal_code": "950203532",
            "telephone_number": "408-847-0888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9460 N NAME UNO STE 210",
            "city": "GILROY",
            "state": "CA",
            "postal_code": "950203532",
            "telephone_number": "408-847-0888",
            "fax_number": "408-847-1257"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARSON",
        "first_name": "KENT",
        "middle_name": "STEVEN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-19",
        "last_updated": "2020-11-06",
        "certification_date": "2020-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CA",
            "license": "G30260",
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "CA",
            "license": "G30260",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stephanie Marie Carrillo
• Suzette Alexias Carrillo
• Melissa Carrisosa
• Liliana G Carrisoza
• Zachary Dean Carroll
• Christina Carter
• Margarita Cartmillendow
• Peter Wayne Casey
• Amber Milagros Casperson
• Anisa Castaneda-Gaeta

• Dermatology Physician in Gilroy, CA
• Providers in Gilroy, CA by specialty
• Dermatology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2020; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.