NPIMap

Individual provider Active NPI

Ryan Carlson, M.D.

  • Psychiatry Physician
  • Robbinsdale, MN
National Provider Identifier
1992238604
Registry record updated Jun 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
64419 Issued in MN
Practice address
3366 Oakdale Ave N Ste 315
Robbinsdale, MN 55422-2967
Phone
(763) 581-5372
NPI assigned
Apr 10, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 28, 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 64419 MN Primary

Addresses

Primary practice location

3366 Oakdale Ave N Ste 315
Robbinsdale, MN 55422-2967

Mailing address

3366 Oakdale Ave N Ste 315
Minneapolis, MN 55422-2967
Phone (763) 581-5372

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
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
I20210601000696 MN Practitioner - Psychiatry 5890050454 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
University of Minnesota Medical School, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Centracare Health System-NR LLCGroup PAC ID 3870739410, 63 clinicians
St Cloud HospitalGroup PAC ID 4880594779, 215 clinicians

Practice addresses (Care Compare)

1013 Hart Blvd
Monticello, MN 55362-8575
Phone (763) 295-2945

1406 6TH Ave N
Saint Cloud, MN 56303-1900
Phone (320) 251-2700

Hospital & facility affiliations

  • Centracare - St. Cloud Hospital Hospital, Saint Cloud, MN, CCN 240036

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Centracare Health System-NR LLC Current Accepting new patients
Centracare Health System-NR LLC CurrentSince Jul 17, 2024 Accepting new patients
Carris Health LLC Psychiatry CurrentSince Jul 17, 2024 Accepting new patients
St. Cloud Hospital Current Accepting new patients
Carris Health LLC CurrentSince Jul 17, 2024 Accepting new patients
St. Cloud Hospital CurrentSince Jul 17, 2024 Accepting new patients

Locations

1013 Hart Blvd
Monticello, MN 55362
Phone (763) 271-2303

1406 6th Ave N
Saint Cloud, MN 56303
Phone (320) 255-5657

110 2nd St S
Ste 104
Waite Park, MN 56387
Phone (320) 259-9375

301 Becker Ave SW
Willmar, MN 56201
Phone (320) 231-4120

Interoperability endpoints

  • Direct secure messaging: rcarlson827250@direct.centracare.com

Organizations & group practices 14

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.

View all 14

Hospital & facility affiliations 6

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": "1491782400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624838400000",
    "number": "1992238604",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3366 OAKDALE AVE N STE 315",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554222967",
            "telephone_number": "763-581-5372"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3366 OAKDALE AVE N STE 315",
            "city": "ROBBINSDALE",
            "state": "MN",
            "postal_code": "554222967",
            "telephone_number": "763-581-5372"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARLSON",
        "first_name": "RYAN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-04-10",
        "last_updated": "2021-06-28",
        "certification_date": "2021-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MN",
            "license": "64419",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Robbinsdale, MN

Sources for this page

Verify at the official NPI Registry.