Keith Harold Carlson, M.D.

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

28116 Issued in MN

Practice address

14101 Fairview Dr Ste 350
Burnsville, MN 55337-2506

Phone

(952) 522-4900

Fax

(952) 522-4901

NPI assigned

Feb 21, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in MN

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

Ophthalmology

Education

University of North Dakota School of Medicine, 1982

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

22.2 of 100Reported as individual

Quality

0

Improvement activities

0

Cost

73.99

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kcarlson92019@excellian.direct.allina.com

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.

• Claris Eye Care & Surgery, P.a.

  • Ophthalmology Physician
  • Burnsville, MN
  • NPI 1841425899
  Medicare reassignment NPD Authorized official
• Ladd Memorial Hospital

  • Clinic/Center
  • Scandia, MN
  • NPI 1700195542
  NPD (past)
• Minneapolis Medical Eye Clinic, P.a.

  • Ophthalmology Physician
  • Minneapolis, MN
  • NPI 1750498465
  NPD (past)

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

{
    "created_epoch": "1140480000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716336000000",
    "number": "1679548879",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14101 FAIRVIEW DR STE 350",
            "city": "BURNSVILLE",
            "state": "MN",
            "postal_code": "553372506",
            "telephone_number": "952-522-4900",
            "fax_number": "952-522-4901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14101 FAIRVIEW DR STE 350",
            "city": "BURNSVILLE",
            "state": "MN",
            "postal_code": "553372506",
            "telephone_number": "952-522-4900",
            "fax_number": "952-522-4901"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARLSON",
        "first_name": "KEITH",
        "middle_name": "HAROLD",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-21",
        "last_updated": "2024-05-22",
        "certification_date": "2024-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "MN",
            "license": "28116",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1679548879",
            "state": "MN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kcarlson92019@excellian.direct.allina.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/PDF/TXT",
            "address_1": "710 E 24th St Ste 205",
            "city": "Minneapolis",
            "state": "MN",
            "country_code": "US",
            "postal_code": "554043810",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Caring Hands Autism Center LLC
• Caring Hearts Services LLC
• Marielyn Carino
• Laura G Carlisle, PHARM.D
• Jill Carlson
• Kelly Marie Carlson, CCC-SLP
• Valerie Rosabel Carlson, FINN
• Brynn Taylor Carlton
• Emma Christine Carpenter
• Tami Michelle Carpenter, RDN, LD, CDE

• Ophthalmology Physician in Burnsville, MN
• Providers in Burnsville, MN by specialty
• Ophthalmology Physician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2024; 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.