Mark Joel Carlson, M.D.
Individual provider Active NPI Family Medicine Physician · Bemidji, MN
NPI 1619904794 · NPPES record last updated Apr 6, 2022
Key facts
- NPI
- 1619904794
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 46685 (MN)
- Practice address
- 1300 Anne St NW
Sanford Health of Northern Minnesota
Bemidji, MN 56601 - Phone
- (218) 751-9746
- Fax
- (218) 333-5228
- NPI assigned
- Jun 26, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 21
Hospital & facility affiliations 4
Medicare Care Compare profile
- Specialty
- Family Practice
- Education
- University of Minnesota Medical School, 2003
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Sanford Health of Northern Minnesota
Practice addresses (Care Compare)
1300 Anne St NW
Bemidji, MN 56601-5103
Phone (218) 333-5000
1611 Anne St NW
Bemidji, MN 56601-5114
Phone (218) 333-5000
Hospital & facility affiliations
- Sanford Bemidji Medical Center
- Sanford Bagley Medical Center
- Lakewood Health Center
Merit-based Incentive Payment System (MIPS)
- Final score
- 86.56 of 100
- Quality
- 74.25
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 76.16
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MN
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20041111000483 | MN | Practitioner - Family Practice | 6507829314 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 46685 | MN | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sanford Health of Northern Minnesota | Current |
Accepting new patients | |
| Sanford Health of Northern Minnesota | Family Medicine | Current |
Accepting new patients |
| Sanford Health of Northern Minnesota | Family Medicine | Current | Accepting new patients |
Locations
1611 Anne St NW
Bemidji, MN 56601
Phone (218) 333-2020
1300 Anne St NW
Bemidji, MN 56601
Phone (218) 333-5794
4000 28th Ave S
Moorhead, MN 56560
Phone (701) 234-3200
1720 US Highway 59 SE
Thief Rvr Fls, MN 56701
Phone (218) 681-4747
3001 Sanford Pkwy
Thief Rvr Fls, MN 56701
Phone (218) 681-4240
Interoperability endpoints
- mcarlson1841718@direct.sanfordhealth.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 46685 | MN | Yes |
Addresses
Primary practice location
1300 Anne St NW
Sanford Health of Northern Minnesota
Bemidji, MN 56601
Mailing address
1300 Anne St NW
Bemidji, MN 56601
Phone (218) 751-9746
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 9831341200 | Medicaid | MN |
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | mcarlson1841718@direct.sanfordhealth.org |
Other providers in Bemidji, MN
- Allan Campbell
- Chase Campbell
- William Lynn Canada
- Kortney Carlin
- Emy Lou Carlson
- Jason Joseph Caron
- James R Carpenter
- Jennifer Carter Berg
- Jessica Carter
- Cas Psychiatric Services PA
All providers in Bemidji, MN · Family Medicine Physician in Minnesota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 6, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.