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ETHAN W CARLSON MD
NPI 1265498588
Family Medicine in Baraboo, WI

Active since April 25, 2006PECOS EnrolledAccepts Medicare Assignment
1700 TUTTLE ST, BARABOO, WI 53913(608) 355-3800(608) 355-7001 Get Directions Write a Review

NPPES record last updated: November 4, 2020. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Nov 4, 2020, Apr 12, 2018, Jan 21, 2016 (3 updates tracked since 2016).

About Ethan W Carlson Md NPPES

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

ETHAN W CARLSON MD (NPI 1265498588) is an individual family medicine provider in Baraboo, Wisconsin, licensed in Wisconsin (37699-020) and active in the NPI registry since April 2006. He is enrolled in Medicare PECOS, is affiliated with Ssm Health St Clare Hospital - Baraboo, and is a graduate of University Of Iowa, Rj & L Carver College Of Medicine (1993).

NPPES Registry Identity

NPI1265498588
Entity TypeIndividualMale
Primary Taxonomy207Q00000X
Provider Legal NameETHAN W CARLSONCredential: MD
Location Address1700 TUTTLE STBaraboo, WI 53913-3319
Mailing Address1700 Tuttle StBaraboo, WI 53913-3319 · (608) 355-3800 · Fax (608) 355-7001
Phone(608) 355-3800
Fax(608) 355-7001
Sole ProprietorNo
Medical School CMSUniversity Of Iowa, Rj & L Carver College Of MedicineGraduated 1993
Enumeration DateApril 25, 2006
Last NPPES UpdateNovember 4, 20203 updates tracked since enumeration
NPPES CertifiedNovember 4, 2020
✔ NPI 1265498588 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in WI · 37699-020
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.

1700 TUTTLE ST, Baraboo, WI 53913
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Other Identifiers 1

Medicaid1265498588WI

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield.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

Ethan W Carlson Md 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 ID1254379753
PECOS Enrollment IDI20050425000104
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 11

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.

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.
349 services219 patients
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439
An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.
142 services142 patients
Administration of influenza virus vaccine G0008
The administration of the influenza virus vaccine, also known as the flu shot, is a simple procedure to protect against the flu. A healthcare provider injects a small dose of the vaccine into your arm. This stimulates your immune system to produce antibodies, which will help your body fight off the flu if exposed.
64 services64 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.
57 services57 patients
Influenza vaccine, inactivated 90653
The Influenza vaccine, inactivated, is a shot given to protect against the flu. It contains killed virus particles that help your body build immunity to the flu. It's recommended annually to keep your protection up-to-date. It's safe for ages 6 months and up.
52 services52 patients
Diabetes outpatient self-management training services, individual, per 30 minutes G0108
This service involves personalized training sessions, each lasting 30 minutes, to help manage diabetes. It includes guidance on monitoring blood sugar, healthy eating, physical activity, medication usage, and dealing with daily challenges of living with diabetes.
38 services19 patients

Hospital Affiliations CMS Care Compare 3

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

Ssm Health St Clare Hospital - Baraboo

Acute Care Hospitals · Baraboo, WI
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number520057
Location707 14th StBaraboo, WI 53913 · Sauk County
Emergency services Birthing friendly

Ssm Health St Mary's Hospital - Madison

Acute Care Hospitals · Madison, WI
5/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number520083
Location700 South Park StMadison, WI 53715 · Dane County
Emergency services Birthing friendly

Reedsburg Area Medical Center

Critical Access Hospitals · Reedsburg, WI
5/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number521351
Location2000 N Dewey AveReedsburg, WI 53959 · Sauk County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 53913 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
$82.92 typical visit price
range $53.90 – $163.24
Typical copayment $20.73 (range $13.47 – $40.81)
Most-billed visit code 99203
Established Patient
$95.41 typical visit price
range $17.40 – $133.76
Typical copayment $23.85 (range $4.35 – $33.44)
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

Colorectal Cancer Screening
Percentage of adults 50-75 years of age who had appropriate screening for colorectal cancer
2%171 patients1/55-star benchmark: 100%
Diabetes: Eye Exam
Percentage of patients 18-75 years of age with diabetes who had a retinal or dilated eye exam by an eye care professional during the measurement period or a negative retinal exam (no evidence of retinopathy) in the 12 months prior to the measurement period
32%47 patients1/55-star benchmark: 100%
Pneumococcal Vaccination Status for Older Adults
Percentage of patients 65 years of age and older who have ever received a pneumococcal vaccine
93%206 patients4/55-star benchmark: 100%
Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan
Percentage of patients aged 18 years and older with a BMI documented during the current encounter or during the previous twelve months AND with a BMI outside of normal parameters, a follow-up plan is documented during the encounter or during the previous…
15%266 patients1/55-star benchmark: 100%
Screening for Osteoporosis for Women Aged 65-85 Years of Age
Percentage of female patients aged 65-85 years of age who ever had a central dual-energy X-ray absorptiometry (DXA) to check for osteoporosis
74%70 patients4/55-star benchmark: 98%
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 5

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

Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253
DME-Other DME · category DE017N
6 suppliers36 claims116 services$5.82 avg. paid by Medicare
Lancets, per box of 100 A4259
DME-Medical/Surgical Supplies · category DA000N
4 suppliers12 claims16 services$0.85 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 suppliers31 claims32 services$19.30 avg. paid by Medicare
Nebulizer, with compressor E0570
DME-Other DME · category DE000N
1 supplier12 claims12 services$8.25 avg. paid by Medicare
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate E1390
DME-Oxygen and Supplies · category DC002N
3 suppliers39 claims40 services$107.53 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 20

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

AME FISCHER CNM
Advanced Practice Midwife
1700 TUTTLE ST
BARABOO, WI 53913
Sauk County (608) 355-3800
CHERYL R GOECKERMANN MD
Internal Medicine (Addiction Medicine)
1700 TUTTLE ST
BARABOO, WI 53913
Sauk County (608) 355-3800
EMILY CATHERINE HORN DO
Student in an Organized Health Care Education/Training Program
1700 TUTTLE ST
BARABOO, WI 53913
Sauk County (608) 355-3800
FAYE J BRICKL
Pharmacist
1700 TUTTLE ST, SUITE 300
BARABOO, WI 53913
Sauk County (608) 356-6966
DR. SARANAH LINSCOTT DO
Family Medicine
1700 TUTTLE ST
BARABOO, WI 53913
Sauk County (608) 355-3800
STUART G HANNAH MD
Family Medicine
1700 TUTTLE ST
BARABOO, WI 53913
Sauk County (608) 355-3800
ANNA BADTKE PA-C
Physician Assistant
1700 TUTTLE ST
BARABOO, WI 53913
Sauk County (608) 355-3800
RANDY J KRSZJZANIEK MD
Family Medicine
1700 TUTTLE ST
BARABOO, WI 53913
Sauk County (608) 355-3800

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 Ethan Carlson's NPI number?

The NPI number for Ethan Carlson is 1265498588. It was assigned to this individual provider in the NPPES registry on April 25, 2006.

Where is Ethan Carlson located?

Ethan Carlson practices at 1700 Tuttle St, Baraboo, WI 53913. The listed phone number is (608) 355-3800.

What is Ethan Carlson's specialty?

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

Is Ethan Carlson enrolled in Medicare?

Yes. Ethan 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 Ethan Carlson accept?

Health plans from Anthem Blue Cross and Blue Shield list Ethan 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 Ethan Carlson affiliated with any hospitals?

According to CMS data, Ethan Carlson is affiliated with Ssm Health St Clare Hospital - Baraboo, Ssm Health St Mary's Hospital - Madison and Reedsburg Area Medical Center.

When was this NPI record last updated?

The NPPES record for Ethan Carlson was last updated on November 4, 2020. NPI Profile syncs with the weekly NPPES data releases published by CMS.