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VERA B CARLSON MD, PHD
NPI 1023095585
Family Medicine in Providence, UT

Active since December 27, 2005PECOS EnrolledAccepts Medicare Assignment
565 W 465 N STE 130, PROVIDENCE, UT 84332(435) 752-5553(435) 755-5043 Get Directions Write a Review

NPPES record last updated: January 31, 2024. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jul 27, 2017, Jul 14, 2016 (2 updates tracked since 2016).

About Vera B Carlson Md, Phd NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

VERA B CARLSON MD, PHD (NPI 1023095585) is an individual family medicine provider in Providence, Utah, licensed in Utah (5916429-8905) and active in the NPI registry since December 2005. She is enrolled in Medicare PECOS, is affiliated with Logan Regional Hospital, and is a graduate of Other (1994).

NPPES Registry Identity

NPI1023095585
Entity TypeIndividualFemale
Primary Taxonomy207Q00000X
Provider Legal NameVERA B CARLSONCredential: MD, PHD
Location Address565 W 465 N STE 130Providence, UT 84332-4802
Mailing Address169 N Gateway Dr Ste 170Providence, UT 84332-9855 · (435) 752-5553 · Fax (435) 755-5043
Phone(435) 752-5553
Fax(435) 755-5043
Sole ProprietorNo
Medical School CMSOtherGraduated 1994
Enumeration DateDecember 27, 2005
Last NPPES UpdateJanuary 31, 20242 updates tracked since enumeration
NPPES CertifiedJanuary 31, 2024
✔ NPI 1023095585 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in UT · 5916429-8905
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
565 W 465 N STE 130, Providence, UT 84332
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include BridgeSpan Health Company, Molina Healthcare, Regence BlueCross BlueShield of Utah and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Vera B Carlson Md, Phd is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID8921057803
PECOS Enrollment IDI20051213000106
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 10

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Advance care planning, first 30 minutes 99497
Advance care planning is a process where you discuss your healthcare preferences with your doctor. This conversation, lasting up to 30 minutes, helps ensure your wishes are respected if you're unable to communicate them in the future. It's about your care, your way.
107 services56 patients
Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
65 services25 patients
Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
64 services19 patients
Subsequent nursing facility care with high level of medical decision making, per day, if using time, at least 45 minutes 99310
A follow-up nursing facility visit is a routine check-up that typically lasts about 35 minutes. During this visit, your health status is evaluated, any changes in your condition are noted, and necessary adjustments to your care plan are made. It's an essential part of maintaining your health.
51 services31 patients
Initial nursing facility care with high level of medical decision making, per day, if using time, 50 minutes or more 99306
An initial nursing facility visit is your first meeting with your healthcare team at a nursing facility. Lasting typically 45 minutes, this appointment involves a comprehensive health assessment and the creation of your personalized care plan. It's a crucial step to ensure your health and well-being.
41 services38 patients
Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes 99309
A follow-up nursing facility visit per day is a daily check-in by a healthcare professional. This 25-minute visit typically involves monitoring your health progress, addressing any concerns, and adjusting treatment plans as necessary. It's a vital part of ensuring your ongoing wellbeing.
35 services24 patients

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Logan Regional Hospital

Acute Care Hospitals · Logan, UT
5/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number460015
Location1400 North 500 EastLogan, UT 84341 · Cache County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 84332 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$84.41 typical visit price
range $54.34 – $166.03
Typical copayment $21.10 (range $13.58 – $41.50)
Most-billed visit code 99203
Established Patient
$96.35 typical visit price
range $17.23 – $135.20
Typical copayment $24.08 (range $4.30 – $33.80)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

Reported Quality Measures

e-Prescribing
At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology.
65%2,206 patients1/55-star benchmark: 99%
Health Information Exchange
The MIPS eligible clinician that transitions or refers their patient to another setting of care or health care clinician (1) uses CEHRT to create a summary of care record; and (2) electronically transmits such summary to a receiving health care clinician for…
82%157 patients4/55-star benchmark: 88%
Patient-Specific Education
The MIPS eligible clinician must use clinically relevant information from CEHRT to identify patient-specific educational resources and provide access to those materials to at least one unique patient seen by the MIPS eligible clinician.
24%323 patients2/55-star benchmark: 97%
Provide Patient Access
At least one patient seen by the MIPS eligible clinician during the performance period is provided timely access to view online, download, and transmit to a third party their health information subject to the MIPS eligible clinician's discretion to withhold…
67%323 patients3/55-star benchmark: 100%
Secure Messaging
For at least one unique patient seen by the MIPS eligible clinician during the performance period, a secure message was sent using the electronic messaging function of CEHRT to the patient (or the patient-authorized representative), or in response to a secure…
89%323 patients5/55-star benchmark: 89%
View, Download, or Transmit (VDT)
At least one patient seen by the MIPS eligible clinician during the performance period (or patient-authorized representative) views, downloads or transmits their health information to a third party during the performance period.
26%323 patients
Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

Referred Medical Equipment & Supplies CMS DME claims 12

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Tubing with integrated heating element for use with positive airway pressure device A4604
DME-Other DME · category DE001N
4 suppliers17 claims17 services$35.55 avg. paid by Medicare
Cushion for use on nasal mask interface, replacement only, each A7032
DME-Other DME · category DE001N
4 suppliers13 claims73 services$13.32 avg. paid by Medicare
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap A7034
DME-Other DME · category DE001N
4 suppliers16 claims16 services$43.64 avg. paid by Medicare
Headgear used with positive airway pressure device A7035
DME-Other DME · category DE001N
5 suppliers13 claims13 services$13.52 avg. paid by Medicare
Filter, disposable, used with positive airway pressure device A7038
DME-Other DME · category DE001N
4 suppliers15 claims86 services$2.69 avg. paid by Medicare
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing E0431
DME-Oxygen and Supplies · category DC000N
3 suppliers20 claims20 services$17.15 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

PEACHTREE FAMILY MEDICINE PC
Family Medicine
565 W 465 N STE 130
PROVIDENCE, UT 84332
Cache County (435) 752-5553
CACHE VALLEY VEIN
Radiology (Vascular & Interventional Radiology)
565 W 465 N STE 130
PROVIDENCE, UT 84332
Cache County (435) 753-2842

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Vera Carlson's NPI number?

The NPI number for Vera Carlson is 1023095585. It was assigned to this individual provider in the NPPES registry on December 27, 2005.

Where is Vera Carlson located?

Vera Carlson practices at 565 W 465 N Ste 130, Providence, UT 84332. The listed phone number is (435) 752-5553.

What is Vera Carlson's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Vera Carlson enrolled in Medicare?

Yes. Vera Carlson is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Vera Carlson accept?

Health plans from BridgeSpan Health Company, Molina Healthcare, Regence BlueCross BlueShield of Utah, Select Health and University of Utah Health Plans list Vera Carlson as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Vera Carlson affiliated with any hospitals?

According to CMS data, Vera Carlson is affiliated with Logan Regional Hospital.

When was this NPI record last updated?

The NPPES record for Vera Carlson was last updated on January 31, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.