Andrea R. Carlsen, MD

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

242634 Issued in NY

Practice address

75 Prospect St Ste 102
Huntington, NY 11743-3320

Phone

(631) 923-0006

Fax

(844) 314-9910

NPI assigned

Nov 14, 2006

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 NY

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

Psychiatry

Education

Vanderbilt University School of Medicine, 1999

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

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.

• North Shore TMS LLC

  • Medical Specialty Clinic/Center
  • Huntington, NY
  • NPI 1497023964
  Medicare reassignment NPD Authorized official
• North Shore TMS

  • Psychiatry Physician
  • Huntington, NY
  • NPI 1467967356
  NPD Authorized official

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

{
    "created_epoch": "1163462400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625011200000",
    "number": "1912079302",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "75 PROSPECT ST STE 102",
            "city": "HUNTINGTON",
            "state": "NY",
            "postal_code": "117433320",
            "telephone_number": "631-923-0006",
            "fax_number": "844-314-9910"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75 PROSPECT ST STE 102",
            "city": "HUNTINGTON",
            "state": "NY",
            "postal_code": "117433320",
            "telephone_number": "631-923-0006",
            "fax_number": "844-314-9910"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "42 Lake Avenue Ext Ste 172",
            "address_purpose": "LOCATION",
            "city": "Danbury",
            "state": "CT",
            "postal_code": "068115279",
            "country_code": "US",
            "telephone_number": "631-923-0006",
            "fax_number": "631-983-3241",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CARLSEN",
        "first_name": "ANDREA",
        "middle_name": "R.",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-14",
        "last_updated": "2021-06-30",
        "certification_date": "2021-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NY",
            "license": "242634",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Andrea Carbajal
• Dena Cardillo, LMSW
• Carillon Dialysis, LLC
• Carillon Nursing & Rehabilitation Center, LLC
• Carillon Nursing and Rehabilitation Center LLC
• Meaghan Carlson
• Melanie Carminati, PT, DPT
• Damon Carnes, RN
• Jessica Carney, INTERN
• Andrea Carollo, M.D.

• Psychiatry Physician in Huntington, NY
• Providers in Huntington, NY by specialty
• Psychiatry Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2021; 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.