Stephen R Carlson, MD

Primary specialty

Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X

License

G49603 Issued in CA

Practice address

9888 Genesee Ave
La Jolla, CA 92037-1205

Phone

(858) 626-6000

NPI assigned

Jul 17, 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

Medicare fee-for-service enrollment

Enrolled in CA

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Laboratory Diagnostics Medical Group

  • Anatomic Pathology & Clinical Pathology Physician
  • La Jolla, CA
  • NPI 1093742074
  NPD Authorized official

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

{
    "created_epoch": "1153094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1487030400000",
    "number": "1902824923",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1801 W OLYMPIC BLVD",
            "address_2": "#1016",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911990001",
            "telephone_number": "800-288-8325",
            "fax_number": "419-866-5453"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9888 GENESEE AVE",
            "city": "LA JOLLA",
            "state": "CA",
            "postal_code": "920371205",
            "telephone_number": "858-626-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARLSON",
        "first_name": "STEPHEN",
        "middle_name": "R",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-17",
        "last_updated": "2017-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "CA",
            "license": "G49603",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G496030",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Cardiac Arrhythmia Associates, a Medical Corporation
• Gabrielle Julia Carella, PA-C
• John M. Carethers, M.D.
• Kayla Lynn Carlisle
• Renee Carlson, P.T.
• Timothy Carpenter, D.M.D.
• Ewa K Carrier, MD
• Crystal Carson
• Dennis Carson, MD
• James Alan Carter, PH.D.

• Anatomic Pathology & Clinical Pathology Physician in La Jolla, CA
• Providers in La Jolla, CA by specialty
• Anatomic Pathology & Clinical Pathology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2017; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.