NPIMap

Individual provider Active NPI

Paul Jeffrey Carlson, MD

  • Psychiatry Physician
  • Gaithersburg, MD
National Provider Identifier
1962515643
Registry record updated Nov 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
D0062133 Issued in MD
Practice address
11B First Field Rd
Gaithersburg, MD 20878
Phone
(301) 990-6880
Fax
(301) 990-0257
NPI assigned
Aug 16, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 11, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X D0062133 MD Primary

Addresses

Primary practice location

11B First Field Rd
Gaithersburg, MD 20878

Mailing address

6123 Montrose Rd
Rockville, MD 20852
Phone (301) 881-3700

Other identifiers 6

IdentifierTypeStateIssuer
406643000MedicaidMD
A2840143OtherDCBCBS OF DC
7363711OtherMDAETNA
64401001OtherMDBCBS OF MD
784453000OtherMDMAGELLAN
247377OtherMDKAISER

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address pcarlson86314@direct.med.utah.edu Direct University of Utah

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT
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
I20080917000024 UT Practitioner - Psychiatry 3577515683 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Baylor College of Medicine, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University of Utah Behavioral Health ServicesGroup PAC ID 9537483607, 185 clinicians
University of Utah Acuity Care ServicesGroup PAC ID 4789908534, 131 clinicians

Practice addresses (Care Compare)

50 N Medical Dr
Salt Lake City, UT 84132-0100
Phone (801) 581-2121

501 S Chipeta Way
Salt Lake City, UT 84108-1222
Phone (801) 587-6336

Hospital & facility affiliations

  • University of Utah Hospital and Clinics Hospital, Salt Lake City, UT, CCN 460009

Merit-based Incentive Payment System (MIPS)

Final score
89.22 of 100Reported as group
Quality
83.74
Promoting interoperability
100
Improvement activities
40
Cost
66.87

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
D0062133MDMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Utah Acuity Care Services Current Accepting new patients
University of Utah Pediatric Acuity Care CurrentSince Jan 20, 2026 Accepting new patients
University of Utah Acuity Care Services CurrentSince Jul 10, 2018 Accepting new patients
University of Utah Acuity Care Services CurrentSince Jul 10, 2018 Accepting new patients
University of Utah Behavioral Health Services CurrentSince Oct 4, 2016 Accepting new patients
University of Utah Pediatric Acuity Care CurrentSince Jan 20, 2026 Accepting new patients
University of Utah Behavioral Health Services CurrentSince Oct 4, 2016 Accepting new patients
University of Utah Behavioral Health Services Psychiatry Current Accepting new patients
Jewish Social Service Agency Psychiatry Past Accepting new patients

Locations

250 E 200 S
Ste 1350
Salt Lake City, UT 84111
Phone 80158763362003

525 E 100 S
Ste 500
Salt Lake City, UT 84102
Phone (801) 519-7190

501 S Chipeta Way
Slc, UT 84108
Phone (801) 581-7951

650 S Komas Dr
Ste 208
Slc, UT 84108
Phone (801) 585-1212

50 N Medical Dr
Slc, UT 84132
Phone (801) 581-2292

Organizations & group practices 10

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 3

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": "1155686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636588800000",
    "number": "1962515643",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6123 MONTROSE RD",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "20852",
            "telephone_number": "301-881-3700",
            "fax_number": "301-468-1862"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11B FIRST FIELD RD",
            "city": "GAITHERSBURG",
            "state": "MD",
            "postal_code": "20878",
            "telephone_number": "301-990-6880",
            "fax_number": "301-990-0257"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARLSON",
        "first_name": "PAUL",
        "middle_name": "JEFFREY",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-16",
        "last_updated": "2021-11-11",
        "certification_date": "2021-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MD",
            "license": "D0062133",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "406643000",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF DC",
            "identifier": "A2840143",
            "state": "DC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7363711",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF MD",
            "identifier": "64401001",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAGELLAN",
            "identifier": "784453000",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KAISER",
            "identifier": "247377",
            "state": "MD"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "pcarlson86314@direct.med.utah.edu",
            "affiliation": "Y",
            "affiliationName": "University of Utah",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/CCD/TXT",
            "address_1": "50 N Medical Dr",
            "city": "Salt Lake City",
            "state": "UT",
            "country_code": "US",
            "postal_code": "841320001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Gaithersburg, MD

Sources for this page

Verify at the official NPI Registry.