Michael Carson, MD

Individual provider Active NPI Emergency Medicine Physician · Ketchikan, AK

NPI 1982165437 · NPPES record last updated Jun 17, 2022

Key facts

NPI
1982165437
Entity type
Individual (NPI type 1)
Primary specialty
Emergency Medicine Physician 207P00000X
License
191010 (AK)
Practice address
3100 Tongass Ave
Ketchikan, AK 99901-5746
Phone
(907) 225-5171
NPI assigned
Mar 27, 2019
Sex
Male
Sole proprietor
No

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.

Medicare Care Compare profile

Merit-based Incentive Payment System (MIPS)

Final score
83.9 of 100 (group)
Quality
76.07
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
79.12 of 100 (group)
Quality
81.91
Promoting interoperability
100
Improvement activities
40
Cost
40.93

Medicare participation

Medicare fee-for-service enrollment
Enrolled in AK
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20220816002644 AK Practitioner - Emergency Medicine 0547593691 Reassigns benefits to 2 organizations

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
191010AKMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mat-Su Emergency Medicine Physicians Corp Emergency Medicine Current
since Jul 1, 2024
Accepting new patients
Nes Washington, Inc. Emergency Medicine Current
since May 18, 2022
Accepting new patients

Locations

3100 Tongass Ave
Ketchikan, AK 99901
Phone (907) 225-4104

2500 S Woodworth Loop
Palmer, AK 99645
Phone (907) 861-6000

Interoperability endpoints

  • Direct secure messaging: mcarson558807@direct.peacehealth.org

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Emergency Medicine Physician 207P00000X 191010 AK Yes

Addresses

Primary practice location

3100 Tongass Ave
Ketchikan, AK 99901-5746

Mailing address

12830 Trent Cir
Anchorage, AK 99516-2761

Other practice location 1

UVMMC 111 Colchester Ave
Burlington, VT 05401
Phone (802) 847-2345

Other providers in Ketchikan, AK

All providers in Ketchikan, AK · Emergency Medicine Physician in Alaska

Sources for this page

Verify at the official NPI Registry.