Active NPI
Douglas J Carlson, M.D.
- Ophthalmology Physician
- Stillwater, MN
National Provider Identifier
1952306243
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ophthalmology Physician
- License
- 21564
- Practice address
- 2950 Curve Crest Blvd W
Stillwater, MN 55082-5085 - Phone
- (651) 275-3000
- Fax
- (651) 275-3027
- NPI assigned
- Jun 15, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ophthalmology Physician | 207W00000X | 21564 | MN | Primary |
Addresses
Primary practice location
2950 Curve Crest Blvd W
Stillwater, MN 55082-5085
Mailing address
1719 Tower Dr W
Ste 100
Stillwater, MN 55082-7512
Phone (651) 275-3000
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 180046280 | Other | WI | RAILROAD MEDICARE |
| 241590900 | Medicaid | MN | |
| 180008787 | Other | MN | RAILROAD MEDICARE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Associated Eye Care Ambulatory Surgery Center LLC | Past | Accepting new patients | |
| Associated Eye Care Optical LLC | Past | Accepting new patients |
Interoperability endpoints
- https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
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 and National Provider Directory roles.
-
- Ophthalmologic Surgery Clinic/Center
- Stillwater, MN
- NPI 1821049958
-
- Eyewear Supplier
- Hudson, WI
- NPI 1205214236
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1118793600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1394150400000",
"number": "1952306243",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1719 TOWER DR W",
"address_2": "STE 100",
"city": "STILLWATER",
"state": "MN",
"postal_code": "550827512",
"telephone_number": "651-275-3000",
"fax_number": "651-275-3027"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2950 CURVE CREST BLVD W",
"city": "STILLWATER",
"state": "MN",
"postal_code": "550825085",
"telephone_number": "651-275-3000",
"fax_number": "651-275-3027"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CARLSON",
"first_name": "DOUGLAS",
"middle_name": "J",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-06-15",
"last_updated": "2014-03-07",
"status": "A"
},
"taxonomies": [
{
"code": "207W00000X",
"taxonomy_group": "",
"desc": "Ophthalmology",
"state": "MN",
"license": "21564",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "180046280",
"state": "WI"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "241590900",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "180008787",
"state": "MN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Stillwater, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.