BENJAMIN CARLSON
NPI 1356572069
Nurse Anesthetist, Certified Registered in Wausau, WI

NPI Status: Active since July 29, 2009

Contact Information

425 PINE RIDGE BLVD
SUITE 211
WAUSAU, WI
ZIP 54401
Phone: (715) 845-5505
Fax: (715) 848-4884

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  • Individual
  • Male
  • Years of Experience 17
  • Nurse Anesthetist, Certified Registered
  • Accepts Insurance
  • Accepts Medicare Approved Payment

About BENJAMIN CARLSON

This page provides the complete NPI Profile along with additional information for Benjamin Carlson, a provider established in Wausau, Wisconsin with a medical specialization in Nurse Anesthetist, Certified Registered and more than 17 years of experience. The healthcare provider is registered in the NPI registry with number 1356572069 assigned on July 2009. The practitioner's primary taxonomy code is 367500000X with license number 158145030 (WI). The provider is registered as an individual and his NPI record was last updated 17 years ago.

NPI
1356572069
Provider Name
BENJAMIN CARLSON
Gender
Male
Entity Type
Individual
Location Address
425 PINE RIDGE BLVD SUITE 211 WAUSAU, WI 54401
Location Phone
(715) 845-5505
Location Fax
(715) 848-4884
Mailing Address
425 PINE RIDGE BLVD SUITE 211 WAUSAU, WI 54401
Medical School Name
OTHER
Graduation Year
2009
Is Sole Proprietor?
Yes
Enumeration Date
07-29-2009
Last Update Date
07-29-2009
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Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Nurse Anesthetist, Certified Registered

Taxonomy Code
367500000X
Type
Physician Assistants & Advanced Practice Nursing Providers
License No.
158145030
License State
WI
Taxonomy Description
(1) A licensed registered nurse with advanced specialty education in anesthesia who, in collaboration with appropriate health care professionals, provides preoperative, intraoperative, and postoperative care to patients and assists in management and resuscitation of critical patients in intensive care, coronary care, and emergency situations. Nurse anesthetists are certified following successful completion of credentials and state licensure review and a national examination directed by the Council on Certification of Nurse Anesthetists. (2) A registered nurse who is qualified by special training to administer anesthesia in collaboration with a physician or dentist and who can assist in the care of patients who are in critical condition.

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

  • Partners HMO Bronze 10600 Ded/10600 MOOP HSA - HMO
  • Partners HMO Bronze 6000 Ded/10600 MOOP HSA - HMO
  • Partners HMO Bronze 7500 Ded/10000 MOOP HSA - HMO
  • Partners HMO Gold 1500 Ded/8000 MOOP with Vision - HMO
  • Partners HMO Gold 2000 Ded/8200 MOOP - HMO
  • Partners HMO Gold 4000 Ded/4000 MOOP HSA - HMO
  • Partners HMO Silver 5500 Ded/8500 MOOP with Vision - HMO
  • Partners HMO Silver 5975 Ded/5975 MOOP HSA - HMO
  • Partners HMO Silver 6000 Ded/8900 MOOP - HMO

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Medicare Participation & PECOS Enrollment Status

Benjamin Carlson is registered with Medicare and accepts claims assignment, this means the provider accepts the approved amount for the cost of rendered services as full payment. Participating providers may not charge beneficiaries more than the approved amount for their services. Please keep in mind that beneficiaries still have to pay a coinsurance or copayment amount for a visit or service.

What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.

  • PECOS PAC ID: 840338166

    What is the PECOS Associate Control ID?
    A PAC ID is a unique 10-digit number assigned to an individual or organization healthcare provider in PECOS. The PAC ID is used to link together all the provider information, like tax identification numbers and organizational names. A PAC ID can be connected to multiple Enrollment IDs if an individual or organization has enrolled in PECOS more than once.

  • PECOS Enrollment ID: I20091106000263

    What is the Provider Enrollment ID?
    The Enrollment ID is a unique alphanumeric 15-digit code assigned to each new provider's PECOS enrollment application. The Enrollment ID is used to link together all the provider enrollment information like enrollment type, state, provider specialty, and reassignment of benefits.

  • Accepts Medicare Assignment? Yes

    What does it mean "accepts medicare assignment"?
    When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
    A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.

Areas of Expertise

The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.

Anesthesia for exam of colon using an endoscope

Anesthesia for a colon examination with an endoscope is a method used to ensure comfort during the procedure. It involves administering medication to help you relax or sleep, thus reducing discomfort as the endoscope, a thin, flexible tube, is navigated through your colon.

This service was performed 20 times for 20 patients

Anesthesia for lens surgery

Anesthesia for lens surgery involves administering medication to numb the eye area, ensuring you feel no pain during the procedure. This can be a local anesthetic (numbing only the eye area) or general (where you're asleep). It helps make the surgery comfortable and stress-free.

This service was performed 13 times for 13 patients

Anesthesia for procedure for total knee joint replacement

Anesthesia for a total knee joint replacement numbs your body to eliminate pain during surgery. This could be general anesthesia where you're unconscious, or regional anesthesia where only the leg is numb. It's administered by a specialist, ensuring safety and comfort.

This service was performed 18 times for 18 patients

Injection by continuous infusion of anesthetic agent and/or steroid into thigh nerve

This procedure involves the slow, steady delivery of a medication into your thigh nerve. An anesthetic agent or steroid is used to manage pain or inflammation. It's a safe, effective way to deliver medication directly to the area that needs it.

This service was performed 16 times for 16 patients

Physician Visit Costs



The typical physician office visit costs for Medicare beneficiaries in this area are: $30.92 for a new patient copayment and $16.84 for an established patient copayment.

The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.

For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.

The prices below reflect the costs for new and established patients in the 54401 ZIP code area.

New Patients Visit Costs *

The most utilized procedure code for new patients office visits is 99204

  • Average New Patient Price $123.69
  • Minimum New Patient Price $53.9
  • Maximum New Patient Price $163.24
  • Average New Patient Copayment $30.92
  • Minimum New Patient Copayment $13.47
  • Maximum New Patient Copayment $40.81

Established Patients Visit Costs *

The most utilized procedure code for established patients office visits is 99213

  • Average Established Patient Price $67.37
  • Minimum Established Patient Price $17.4
  • Maximum Established Patient Price $133.76
  • Average Established Patient Copayment $16.84
  • Minimum Established Patient Copayment $4.35
  • Maximum Established Patient Copayment $33.44

* The physician office visit costs information is generated by statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.

Find Provider Hospital Affiliations - Privileges

Doctors and physicians must apply for hospital privileges to treat patients at hospitals. Find out if your doctor has privileges to practice at your preferred hospital by using the hospital affiliation information below based on recent medical claims.

Hospital affiliation is identified through self-reporting data, inpatient, outpatient, physician and ancillary service claims linked by the medical claims NPI number and place of service code. Additionally, to further determine provider hospital affiliation the clinician must have provided services to at least three patients on three different dates in the last 12 months. Benjamin Carlson is affiliated with the following medical facilities:

Hospital Name Address Phone Hospital Type Overall Rating
SAUK PRAIRIE HOSPITAL260 26TH STREET
PRAIRIE DU SAC, WI 53578
(608) 643-3311Acute Care Hospitals

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NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1356572069, we treat the final digit (9) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 51. The final step is to find the difference between that total and the next multiple of ten (60 - 51 = 9).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1
1
Doubled → 2
Pos 2
3
Unchanged
Pos 3
5
Doubled → 10 → 1 + 0
Pos 4
6
Unchanged
Pos 5
5
Doubled → 10 → 1 + 0
Pos 6
7
Unchanged
Pos 7
2
Doubled → 4
Pos 8
0
Unchanged
Pos 9
6
Doubled → 12 → 1 + 2
Check
9
Target digit
Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 5 → 10 → 1 5 → 10 → 1 2 → 4 6 → 12 → 3

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 3 + 1 + 0 + 6 + 1 + 0 + 7 + 4 + 0 + 1 + 2 + 24 = 51

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 51 is 60. The difference is the calculated check digit.

60 - 51 = 9
This NPI is valid
The calculated check digit is 9, which matches the last digit of 1356572069.

Other Providers at the Same Location


The following 20 providers are registered at the same or a nearby location.

Plastic Surgery
425 PINE RIDGE BLVD, SUITE 205
WAUSAU, WI 54401
Nurse Anesthetist, Certified Registered
425 PINE RIDGE BLVD, SUITE 211
WAUSAU, WI 54401
Internal Medicine (Critical Care Medicine)
425 PINE RIDGE BLVD, SUITE 220
WAUSAU, WI 54401
Nurse Anesthetist, Certified Registered
425 PINE RIDGE BLVD, STE 211
WAUSAU, WI 54401
Anesthesiology
425 PINE RIDGE BLVD
WAUSAU, WI 54401
Anesthesiology
425 PINE RIDGE BLVD, SUITE 211
WAUSAU, WI 54401
Thoracic Surgery (Cardiothoracic Vascular Surgery)
425 PINE RIDGE BLVD, SUITE 209
WAUSAU, WI 54401
Thoracic Surgery (Cardiothoracic Vascular Surgery)
425 PINE RIDGE BLVD, SUITE 209
WAUSAU, WI 54401
Anesthesiology
425 PINE RIDGE BLVD, SUITE 211
WAUSAU, WI 54401
Anesthesiology
425 PINE RIDGE BLVD, SUITE 211
WAUSAU, WI 54401
Nurse Anesthetist, Certified Registered
425 PINE RIDGE BLVD, SUITE 211
WAUSAU, WI 54401
Anesthesiology
425 PINE RIDGE BLVD, SUITE 211
WAUSAU, WI 54401
Internal Medicine
425 PINE RIDGE BLVD, SUITE 305B
WAUSAU, WI 54401
Nurse Anesthetist, Certified Registered
425 PINE RIDGE BLVD, SUITE 211
WAUSAU, WI 54401
Physician Assistant (Surgical)
425 PINE RIDGE BLVD, SUITE 209
WAUSAU, WI 54401
Anesthesiology
425 PINE RIDGE BLVD, SUITE 211
WAUSAU, WI 54401
Anesthesiology
425 PINE RIDGE BLVD, SUITE 211
WAUSAU, WI 54401
Anesthesiology
425 PINE RIDGE BLVD, SUITE 211
WAUSAU, WI 54401
Nurse Anesthetist, Certified Registered
425 PINE RIDGE BLVD, SUITE 211
WAUSAU, WI 54401
Nurse Anesthetist, Certified Registered
425 PINE RIDGE BLVD, SUITE 211
WAUSAU, WI 54401

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1356572069, enumerated as an "individual" on July 29, 2009.

The provider is located at 425 PINE RIDGE BLVD SUITE 211 WAUSAU, WI 54401 and the phone number is (715) 845-5505.

Nurse Anesthetist, Certified Registered with taxonomy code 367500000X.

The provider might be accepting Accepts: Group Health Cooperative-SCW. Please consult your insurance carrier or call the provider to verify.

Benjamin Carlson is affiliated with: SAUK PRAIRIE HOSPITAL.