IVY MCKENZIE CARSON NP
NPI 1023409034
Nurse Practitioner - Primary Care in West Hollywood, CA

Q: What is Ivy Carson's NPI number?

The NPI number for Ivy Carson is 1023409034. It was assigned to this individual provider in the NPPES registry on February 12, 2015.

Q: What is Ivy Carson's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Primary Care, with taxonomy code 363LP2300X.

Q: Is Ivy Carson enrolled in Medicare?

No. Ivy Carson has opted out of Medicare through October 1, 2027. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out. The provider remains eligible to order and refer services for Medicare patients.

Q: When was this NPI record last updated?

The NPPES record for Ivy Carson was last updated on March 28, 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.

Active since February 12, 2015Opted out of Medicare · through Oct 1, 2027

8550 SANTA MONICA BLVD FL 2, WEST HOLLYWOOD, CA 90069(909) 962-1260(323) 307-7140 Get Directions Write a Review

NPPES record last updated: March 28, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Dec 23, 2022, Nov 30, 2020, Jan 3, 2017 (3 updates tracked since 2017).

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About Ivy Mckenzie Carson Np NPPES

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

IVY MCKENZIE CARSON NP (NPI 1023409034) is an individual primary care provider in West Hollywood, California, licensed in Michigan (4704279990) and active in the NPI registry since February 2015. She has opted out of Medicare through October 1, 2027 and remains eligible to order and refer and maintains 9 additional practice locations.

NPPES Registry Identity

NPI1023409034

Entity TypeIndividualFemale

Primary Taxonomy363LP2300X

Provider Legal NameIVY MCKENZIE CARSONCredential: NP

Location Address8550 SANTA MONICA BLVD FL 2West Hollywood, CA 90069-4496

Mailing Address8550 Santa Monica Blvd Fl 2West Hollywood, CA 90069-4496 · (909) 962-1260 · Fax (323) 307-7140

Phone(909) 962-1260

Fax(323) 307-7140

Sole ProprietorNo

Enumeration DateFebruary 12, 2015

Last NPPES UpdateMarch 28, 20243 updates tracked since enumeration

NPPES CertifiedMarch 28, 2024

✔ NPI 1023409034 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyNurse Practitioner · Primary CarePhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LP2300X

License✔ Licensed in MI · 4704279990

Also ListedNurse Practitioner · Adult HealthTaxonomy 363LA2200X · License 4704279990 (MI)

Also ListedNurse Practitioner · GerontologyTaxonomy 363LG0600X · License 4704279990 (MI)

8550 SANTA MONICA BLVD FL 2, West Hollywood, CA 90069

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Secondary Practice Locations 9

Location 11729 W Tilghman St Ste 2Allentown, PA 18104-4158 · Phone (866) 824-3495

Location 2330 Changebridge Rd Ste 101Pine Brook, NJ 07058-9839 · Phone (866) 824-3495

Location 37014 13th Ave Ste 202Brooklyn, NY 11228-1604 · Phone (866) 824-3495

Location 49900 Corporate Campus Dr Ste 3000Louisville, KY 40223-4060 · Phone (866) 824-3495

Location 51215 24th St W Ste 125Billings, MT 59102-3895 · Phone (866) 824-3495

Location 65575 S Semoran Blvd Ste 36Orlando, FL 32822-1782 · Phone (866) 824-3495

Location 7336 W 1st St Ste 113Flint, MI 48502-1382 · Phone (866) 824-3495

Location 8121 S Tejon St Ste 900Colorado Springs, CO 80903-2207 · Phone (866) 824-3495

Location 99900 Spectrum DrAustin, TX 78717-4555 · Phone (866) 824-3495

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

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Opted out of Medicare

Ivy Mckenzie Carson Np has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from October 1, 2021 through October 1, 2027.

Opt-Out Effective DateOctober 1, 2021

Opt-Out In Effect ThroughOctober 1, 2027Opt-out affidavits renew automatically every two years unless cancelled

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesAn opted-out provider can still order and refer for Medicare patients in the categories marked above, even though their own services are not covered.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 90069 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

$96.36 typical visit price

range $62.96 – $187.60

Typical copayment $24.09 (range $15.74 – $46.90)

Most-billed visit code 99203

Established Patient

$109.96 typical visit price

range $20.84 – $153.61

Typical copayment $27.49 (range $5.21 – $38.40)

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.

Other Providers at the Same Location NPPES 20

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

CAROLYN FRANCES KRIEG D.O.

Internal Medicine