Waldo B Carlson, MD is a medicare enrolled "Preventive Medicine - Preventive Medicine/occupational Environmental Medicine" physician in Iron Mountain, Michigan. His current practice location is
1707 S Stephenson Ave, Iron Mountain, Michigan. You can reach out to his office (for appointments etc.) via phone at
(906) 779-7111.
Waldo B Carlson is licensed to practice in Michigan (license number 4301043955) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1356324214.
Physician's Profile
| Full Name | Waldo B Carlson |
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| Gender | Male |
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| Speciality | Preventive Medicine - Preventive Medicine/occupational Environmental Medicine |
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| Location | 1707 S Stephenson Ave, Iron Mountain, Michigan |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1356324214
- Provider Enumeration Date: 11/23/2005
- Last Update Date: 11/17/2022
Medicare PECOS Information:
- PECOS PAC ID: 1052449741
- Enrollment ID: I20100518000258
Medical Identifiers
Medical identifiers for Waldo B Carlson such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
| 1356324214 | NPI | - | NPPES |
| 30551400 | Medicaid | WI | |
| 3228033 | Medicaid | MI | |
| 110088084 | Other | MI | RR MEDICARE |
| 3902200121 | Other | MI | BCBS MI |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
| 207R00000X | Internal Medicine | 4301043955 (Michigan) | Secondary |
| 2083P0011X | Preventive Medicine - Undersea And Hyperbaric Medicine | 4301043955 (Michigan) | Secondary |
| 2083P0500X | Preventive Medicine - Preventive Medicine/occupational Environmental Medicine | 4301043955 (Michigan) | 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. Waldo B Carlson allows following entities to bill medicare on his behalf.
| Entity Name | Dickinson County Healthcare System |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1891751186 PECOS PAC ID: 6800784943 Enrollment ID: O20040310000583 |
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| Entity Name | Dickinson County Healthcare System |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1891751186 PECOS PAC ID: 6800784943 Enrollment ID: O20040430000580 |
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| Entity Name | Dickinson County Healthcare System |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1891751186 PECOS PAC ID: 6800784943 Enrollment ID: O20050623000153 |
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| Entity Name | Bell Physician Practices Inc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1578992491 PECOS PAC ID: 4981833654 Enrollment ID: O20140130000127 |
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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. Waldo B 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 |
Waldo B Carlson, MD Po Box 549, Iron Mountain, MI 49801-0549 Ph: (906) 774-1313 | Waldo B Carlson, MD 1707 S Stephenson Ave, Iron Mountain, MI 49801-3637 Ph: (906) 779-7111 |
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