NPIMap

Individual provider Active NPI

Richard Andrew Carlson Jr, MD

  • Internal Medicine Physician
  • Tonawanda, NY
National Provider Identifier
1740246735
Registry record updated Jan 25, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
183745 Issued in NY
Practice address
1491 Sheridan Dr
Sheridan Medical Group
Tonawanda, NY 14217-1234
Phone
(716) 332-4476
Fax
(716) 332-4479
NPI assigned
Apr 26, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 183745 NY Primary
Geriatric Medicine (Internal Medicine) Physician 207RG0300X 183745 NY

Addresses

Primary practice location

1491 Sheridan Dr
Sheridan Medical Group
Tonawanda, NY 14217-1234

Mailing address

1491 Sheridan Dr
Tonawanda, NY 14217-1234
Phone (716) 332-4476

Other identifiers 1

IdentifierTypeStateIssuer
01226122MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110622000566 NY Practitioner - Internal Medicine 3072425537 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Creighton University School of Medicine, 1978
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Sheridan Drive Medical Group LLPGroup PAC ID 8820900376, 9 clinicians
Geriatric Associates, LLPGroup PAC ID 8426944851, 5 clinicians

Practice addresses (Care Compare)

1491 Sheridan Dr
Suite 100
Tonawanda, NY 14217-1234
Phone 7163324476323

275 Northepoint Pkwy
Suite 50
Amherst, NY 14228-1895
Phone (716) 834-1191

Hospital & facility affiliations

  • McAuley Seton Home Care Corp Chha Home health agency, Buffalo, NY, CCN 337251
  • Amedisys Home Health Care (Amherst) Home health agency, Williamsville, NY, CCN 337248
  • Hospice Buffalo Inc Hospice, Cheektowaga, NY, CCN 331502
  • Sisters of Charity Hospital Hospital, Buffalo, NY, CCN 330078
  • Kaleida Health Hospital, Buffalo, NY, CCN 330005
  • Kenmore Mercy Hospital Hospital, Kenmore, NY, CCN 330102
  • Elderwood at Amherst Nursing home, Amherst, NY, CCN 335056
  • Schofield Residence Nursing home, Kenmore, NY, CCN 335603

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
183745NYMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sheridan Drive Medical Group LLP Internal Medicine CurrentSince Jan 1, 2003 Accepting new patients
Geriatric Associates, LLP Geriatric Medicine CurrentSince Aug 18, 2003 Accepting new patients
4459 Bailey Avenue Operating Company LLC Past Accepting new patients

Locations

275 Northpointe Pkwy
Ste 50
Buffalo, NY 14228
Phone (716) 389-3294

4650 Southwestern Blvd
Hamburg, NY 14075
Phone (716) 648-2450

1491 Sheridan Dr
Ste 100
Tonawanda, NY 14217
Phone (716) 332-4476

1491 Sheridan Dr
Tonawanda, NY 14217
Phone (716) 332-4476

Interoperability endpoints

  • Direct secure messaging: rcarlson@sheridanmedgroup.medentdirect.com
  • FHIR API: https://fhir.medent.com/fhir/R4/3P171181

Organizations & group practices 3

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.

Hospital & facility affiliations 14

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

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1146009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1359072000000",
    "number": "1740246735",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1491 SHERIDAN DR",
            "city": "TONAWANDA",
            "state": "NY",
            "postal_code": "142171234",
            "telephone_number": "716-332-4476",
            "fax_number": "716-332-4479"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1491 SHERIDAN DR",
            "address_2": "SHERIDAN MEDICAL GROUP",
            "city": "TONAWANDA",
            "state": "NY",
            "postal_code": "142171234",
            "telephone_number": "716-332-4476",
            "fax_number": "716-332-4479"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARLSON JR",
        "first_name": "RICHARD",
        "middle_name": "ANDREW",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-26",
        "last_updated": "2013-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "183745",
            "primary": true
        },
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "NY",
            "license": "183745",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01226122",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tonawanda, NY

Sources for this page

Verify at the official NPI Registry.