Diana Jolynn Carlson, D.O.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

5101017651 Issued in MI

Practice address

100 N Pond Dr
Suite C
Walled Lake, MI 48390-3079

Phone

(248) 624-2222

Fax

(248) 926-9455

NPI assigned

Oct 9, 2008

Last updated

Apr 14, 2014By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

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

Internal Medicine

Education

At Still University of Health Sciences, College of Osteo Med, Kirksville, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Pillay Internal Medicine Associates, PLLCGroup PAC ID 1254301880, 3 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Huron Valley-Sinai Hospital Hospital, Commerce Township, MI, CCN 230277

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: dcarlson2@direct.dmc.org
• Direct secure messaging: dcarlson281726@direct.hfhs.org
• Direct secure messaging: diana.carlson.1@8372.direct.athenahealth.com
• FHIR API: https://api.platform.athenahealth.com/8372/brand/1/csg/1/fhir/r4

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.

• Pillay Internal Medicine Associates, PLLC

  • Primary Care Clinic/Center
  • Walled Lake, MI
  • NPI 1003800269
  Medicare reassignment Care Compare group NPD
• VHS Huron Valley-Sinai Hospital Inc

  dba Huron Valley-Sinai Hospital

  • General Acute Care Hospital
  • Commerce Township, MI
  • NPI 1922310200
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• VHS Huron Valley-Sinai Hospital Inc

  dba Huron Valley-Sinai Hospital

  • General Acute Care Hospital
  • Commerce Township, MI
  • NPI 1922310200
  Care Compare affiliation

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

{
    "created_epoch": "1223510400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1397433600000",
    "number": "1689825564",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 N POND DR",
            "address_2": "SUITE C",
            "city": "WALLED LAKE",
            "state": "MI",
            "postal_code": "483903079",
            "telephone_number": "248-624-2222",
            "fax_number": "248-926-9455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 N POND DR",
            "address_2": "SUITE C",
            "city": "WALLED LAKE",
            "state": "MI",
            "postal_code": "483903079",
            "telephone_number": "248-624-2222",
            "fax_number": "248-926-9455"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARLSON",
        "first_name": "DIANA",
        "middle_name": "JOLYNN",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-10-09",
        "last_updated": "2014-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "5101017651",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Jeffrie Kon Cape, LMSW
• Tia Fianna Carter, LLC
• Timothy J Carter, D.C.
• George Georges Chabiaa, D.D.S.,
• Chiropractic Care Center Inc.
• City of Walled Lake (Walled Lake Fire Department)

• Internal Medicine Physician in Walled Lake, MI
• Providers in Walled Lake, MI by specialty
• Internal Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2014; 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.