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SCOTT CARLSON M.D.
NPI 1356667513
Pediatrics in Cincinnati, OH

Active since April 13, 2010PECOS EnrolledAccepts Medicare Assignment
234 GOODMAN ST., ML 665X, HOXWORTH MEDICINE-PEDIATRICS CLINIC, CINCINNATI, OH 45219(513) 584-7425(513) 584-7681 Get Directions Write a Review

NPPES record last updated: February 14, 2014. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Scott Carlson M.d. NPPES

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

SCOTT CARLSON M.D. (NPI 1356667513) is an individual pediatrics provider in Cincinnati, Ohio, licensed in Ohio (35.121654) and active in the NPI registry since April 2010. He is enrolled in Medicare PECOS, is affiliated with Riverside Methodist Hospital, and is a graduate of University Of Cincinnati College Of Medicine (2010).

NPPES Registry Identity

NPI1356667513
Entity TypeIndividualMale
Primary Taxonomy208000000X
Provider Legal NameSCOTT CARLSONCredential: M.D.
Location Address234 GOODMAN ST., ML 665X, HOXWORTH MEDICINE-PEDIATRICS CLINICCincinnati, OH 45219
Mailing Address234 Goodman St., Ml 665x, Hoxworth Medicine-pediatrics ClinicCincinnati, OH 45219 · (513) 584-7425 · Fax (513) 584-7681
Phone(513) 584-7425
Fax(513) 584-7681
Sole ProprietorNo
Medical School CMSUniversity Of Cincinnati College Of MedicineGraduated 2010
Enumeration DateApril 13, 2010
Last NPPES UpdateFebruary 14, 2014
✔ NPI 1356667513 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians
Taxonomy Code208000000X
License✔ Licensed in OH · 35.121654
Definition
A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.
Also ListedInternal MedicineTaxonomy 207R00000X · License 35.121654 (OH)
234 GOODMAN ST., ML 665X, Cincinnati, OH 45219
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include CareSource, Oscar Health Insurance, UnitedHealthcare.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

Scott Carlson M.d. 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 ID9032332572
PECOS Enrollment IDI20140602000690
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 4

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.
304 services145 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.
98 services98 patients
Hemoglobin a1c level 83036
Hemoglobin A1c (HbA1c) is a test that measures your average blood sugar level over the past 2-3 months. It's used to monitor how well diabetes is being controlled. High levels may indicate that your diabetes treatment plan needs adjustment.
36 services21 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.
20 services16 patients

Hospital Affiliations CMS Care Compare 3

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

Riverside Methodist Hospital

Acute Care Hospitals · Columbus, OH
5/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number360006
Location3535 Olentangy River RdColumbus, OH 43214 · Franklin County
Emergency services Birthing friendly

Mount Carmel St Ann's

Acute Care Hospitals · Westerville, OH
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number360012
Location500 South Cleveland AvenueWesterville, OH 43081 · Franklin County
Emergency services Birthing friendly

Mount Carmel East & West

Acute Care Hospitals · Columbus, OH
2/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number360035
Location6001 East Broad StreetColumbus, OH 43213 · Franklin County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 45219 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
$84.72 typical visit price
range $54.34 – $166.65
Typical copayment $21.18 (range $13.58 – $41.66)
Most-billed visit code 99203
Established Patient
$96.44 typical visit price
range $17.10 – $135.40
Typical copayment $24.11 (range $4.27 – $33.85)
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.

Referred Medical Equipment & Supplies CMS DME claims 2

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
7 suppliers18 claims52 services$6.11 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
2 suppliers17 claims17 services$14.33 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

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 Scott Carlson's NPI number?

The NPI number for Scott Carlson is 1356667513. It was assigned to this individual provider in the NPPES registry on April 13, 2010.

Where is Scott Carlson located?

Scott Carlson practices at 234 Goodman St., Ml 665X Hoxworth Medicine-Pediatrics Clinic, Cincinnati, OH 45219. The listed phone number is (513) 584-7425.

What is Scott Carlson's specialty?

The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.

Is Scott Carlson enrolled in Medicare?

Yes. Scott 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 Scott Carlson accept?

Health plans from CareSource, Oscar Health Insurance and UnitedHealthcare list Scott 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 Scott Carlson affiliated with any hospitals?

According to CMS data, Scott Carlson is affiliated with Riverside Methodist Hospital, Mount Carmel St Ann's and Mount Carmel East & West.

When was this NPI record last updated?

The NPPES record for Scott Carlson was last updated on February 14, 2014. NPI Profile syncs with the weekly NPPES data releases published by CMS.