Individual provider Active NPI

David J Carlson, M.D.

  • Internal Medicine Physician
  • Milford, MA
National Provider Identifier
1871695296
Registry record updated Nov 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
227107 Issued in MA
Practice address
101 Cedar St
Milford, MA 01757-1101
Phone
(508) 634-5026
Fax
(508) 634-5005
NPI assigned
Sep 5, 2006
Last updated
Nov 8, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 8, 2021

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 227107 MA Primary
Pediatrics Physician 208000000X 227107 MA

Addresses

Primary practice location

101 Cedar St
Milford, MA 01757-1101

Mailing address

101 Cedar St
Milford, MA 01757-1101
Phone (508) 634-5026

Other practice location 1

24 Newton St
Southborough, MA 01772-1215
Phone (508) 460-3250

Other practice location 2

367 Plantation St
Worcester, MA 01605-2323
Phone (508) 334-1443

Other identifiers 2

IdentifierTypeStateIssuer
110077492AMedicaidMA
1100777492AMedicaidMA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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

Enrollment IDStateProvider typePAC IDDetails
I20080118000544 MA Practitioner - Internal MedicinePractitioner - Pediatric Medicine 8729169487 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Pediatric Medicine
Education
University of Massachusetts Medical School, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Reliant Medical Group IncGroup PAC ID 5597755322, 638 clinicians

Practice addresses (Care Compare)

101 Cedar St
Milford, MA 01757-1101
Phone (508) 634-3100

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Reliant Medical Group, Inc Internal Medicine CurrentSince Oct 12, 2020 Accepting new patients
Reliant Medical Group, Inc Past Accepting new patients

Locations

101 Cedar St
Milford, MA 01757
Phone (508) 634-5000

24 Newton St
Southborough, MA 01772
Phone (508) 460-3190

5 Neponset St
Worcester, MA 01606
Phone (508) 595-2300

Organizations & group practices 2

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1157414400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636329600000",
    "number": "1871695296",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 CEDAR ST",
            "city": "MILFORD",
            "state": "MA",
            "postal_code": "017571101",
            "telephone_number": "508-634-5026",
            "fax_number": "508-634-5005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 CEDAR ST",
            "city": "MILFORD",
            "state": "MA",
            "postal_code": "017571101",
            "telephone_number": "508-634-5026",
            "fax_number": "508-634-5005"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "24 Newton St",
            "address_purpose": "LOCATION",
            "city": "Southborough",
            "state": "MA",
            "postal_code": "017721215",
            "country_code": "US",
            "telephone_number": "508-460-3250",
            "fax_number": "508-453-8152",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "367 Plantation St",
            "address_purpose": "LOCATION",
            "city": "Worcester",
            "state": "MA",
            "postal_code": "016052323",
            "country_code": "US",
            "telephone_number": "508-334-1443",
            "fax_number": "508-334-1448",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CARLSON",
        "first_name": "DAVID",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-05",
        "last_updated": "2021-11-08",
        "certification_date": "2021-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MA",
            "license": "227107",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MA",
            "license": "227107",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110077492A",
            "state": "MA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1100777492A",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Milford, MA

Sources for this page

Verify at the official NPI Registry.