Dr Misty Dawn Carlson, DO is a medicare enrolled "Internal Medicine" physician in Ft Sam Houston, Texas. Her current practice location is
Bamc 3851 Roger Brooke Dr, Mche-qd (cred), Ft Sam Houston, Texas. You can reach out to her office (for appointments etc.) via phone at
(210) 916-3027.
Dr Misty Dawn Carlson is licensed to practice in Nebraska (license number 457) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1083662324.
Physician's Profile
| Full Name | Dr Misty Dawn Carlson |
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| Gender | Female |
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| Speciality | Internal Medicine |
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| Location | Bamc 3851 Roger Brooke Dr, Ft Sam Houston, Texas |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1083662324
- Provider Enumeration Date: 05/05/2006
- Last Update Date: 07/08/2007
Medicare PECOS Information:
- PECOS PAC ID: 5597031294
- Enrollment ID: I20250307000127
Medical Identifiers
Medical identifiers for Dr Misty Dawn Carlson such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1083662324 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 207R00000X | Internal Medicine | 457 (Nebraska) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Dr Misty Dawn Carlson allows following entities to bill medicare on her behalf.
| Entity Name | Omaha Tribe Of Nebraska |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1871977918
PECOS PAC ID: 7315467560
Enrollment ID: O20250219000691 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Misty Dawn Carlson is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
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Dr Misty Dawn Carlson, DO
250 Treeline Park, #1315,
San Antonio, TX 78209-1882
Ph: (210) 364-0960 | Dr Misty Dawn Carlson, DO
Bamc 3851 Roger Brooke Dr, Mche-qd (cred),
Ft Sam Houston, TX 78234-6200
Ph: (210) 916-3027 |
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