Annelise M Carlson, MD

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

48435 Issued in MN

Practice address

5228 Evanswood LN
Minneapolis, MN 55436-1133

Phone

(952) 595-1100

Fax

(612) 294-4903

NPI assigned

Nov 22, 2006

Sex

Female

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 MN, WI, CA, TX4 enrollments

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 4

Specialty

Diagnostic Radiology

Education

University of Minnesota Medical School, 2003

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Gila River Health Care CorporationGroup PAC ID 0648174185, 245 clinicians

Smi Imaging LLCGroup PAC ID 3476696220, 380 clinicians

Simonmed Imaging Florida LLCGroup PAC ID 6608036108, 302 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

89.21 of 100Reported as group

Quality

76.88

Promoting interoperability

76

Improvement activities

40

Cost

73.83

Merit-based Incentive Payment System (MIPS)

Final score

79.36 of 100Reported as group

Quality

75.71

Improvement activities

40

Merit-based Incentive Payment System (MIPS)

Final score

79.36 of 100Reported as group

Quality

75.71

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles (13 of 15)

Locations (25 of 36)

Networks

• Freedom Health HMO Network
• Optimum HealthCare HMO Network

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.

• Gila River Health Care Corporation

  • Critical Access Hospital
  • Laveen, AZ
  • NPI 1376538231

  TX

  Medicare reassignment Care Compare group NPD
• Simonmed Imaging Florida LLC

  • Diagnostic Radiology Physician
  • Tampa, FL
  • NPI 1477830818

  MN

  Medicare reassignment Care Compare group NPD
• Smi Imaging, LLC

  • Diagnostic Radiology Physician
  • Scottsdale, AZ
  • NPI 1972004489

  MN

  Medicare reassignment Care Compare group NPD
• Howard Simon MD PLLC

  • Diagnostic Radiology Physician
  • Chicago, IL
  • NPI 1659930998

  MN

  Medicare reassignment NPD
• Milwaukee Health Services, Inc.

  • Federally Qualified Health Center (FQHC)
  • Milwaukee, WI
  • NPI 1518005818
  Medicare reassignment NPD
• Simonmed Reno PLLC

  • Diagnostic Radiology Physician
  • Reno, NV
  • NPI 1306576145

  MN

  Medicare reassignment NPD
• Health Diagnostics of California a Professional Corporation

  • Diagnostic Radiology Physician
  • Mountain View, CA
  • NPI 1104321959
  Medicare reassignment
• St. Croix Regional Medical Center

  • Critical Access Hospital
  • Saint Croix Falls, WI
  • NPI 1043240922

  MN

  Medicare reassignment
• Gila River Health Care

  • Community/Behavioral Health Agency
  • Laveen, AZ
  • NPI 1598021495
  NPD
• Gila River Health Care Corporation

  • Rural Acute Care Hospital
  • Maricopa, AZ
  • NPI 1386633915
  NPD
• Gila River Health Care Corporation

  • Community/Behavioral Health Agency
  • Chandler, AZ
  • NPI 1821599424
  NPD
• Health Diagnostics of California a Professional Corporation

  • Diagnostic Radiology Physician
  • Laguna Hills, CA
  • NPI 1245861368
  NPD

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

{
    "created_epoch": "1164153600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646265600000",
    "number": "1720153075",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11995 SINGLETREE LN",
            "address_2": "STE 500",
            "city": "EDEN PRAIRIE",
            "state": "MN",
            "postal_code": "553445347",
            "telephone_number": "952-595-1301",
            "fax_number": "612-294-4903"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5228 EVANSWOOD LN",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554361133",
            "telephone_number": "952-595-1100",
            "fax_number": "612-294-4903"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARLSON",
        "first_name": "ANNELISE",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-22",
        "last_updated": "2022-03-03",
        "certification_date": "2022-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "WI",
            "license": "60206",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MN",
            "license": "48435",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hannah Jean Carlin, PA-C
• Peter Carlin, LGSW
• Susan Marie Carlin, MS, MSSW, LICSW
• Camille Carlson Ortiz
• Andrew John Carlson, MD
• Bayard Chandler Carlson, M.D.
• Becky Marie Carlson, REGISTERED NURSE
• Bradley David Carlson, PHARMD
• Brittni Carlson, LADC, LPCC
• Cara L Carlson, MSW. LICSW

• Diagnostic Radiology Physician in Minneapolis, MN
• Providers in Minneapolis, MN by specialty
• Diagnostic Radiology Physician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2022; 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.