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GARY CARLSON MD
NPI 1497700116
Internal Medicine in Newport Beach, CA

Active since May 23, 2006PECOS EnrolledAccepts Medicare Assignment
83.01/100
CMS Quality Rating
520 SUPERIOR AVE, SUITE 220, NEWPORT BEACH, CA 92663(949) 722-3300(949) 548-9465 Get Directions Write a Review

NPPES record last updated: August 10, 2011. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Gary Carlson Md NPPES

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

GARY CARLSON MD (NPI 1497700116) is an individual internal medicine provider in Newport Beach, California, licensed in California (G80564) and active in the NPI registry since May 2006. He is enrolled in Medicare PECOS and is a graduate of Other (1993).

NPPES Registry Identity

NPI1497700116
Entity TypeIndividualMale
Primary Taxonomy207R00000X
Provider Legal NameGARY CARLSONCredential: MD
Location Address520 SUPERIOR AVE, SUITE 220Newport Beach, CA 92663-3637
Mailing Address520 Superior Ave, Suite 220Newport Beach, CA 92663-3637 · (949) 722-3300 · Fax (949) 548-9465
Phone(949) 722-3300
Fax(949) 548-9465
Sole ProprietorNo
Medical School CMSOtherGraduated 1993
Enumeration DateMay 23, 2006
Last NPPES UpdateAugust 10, 2011
✔ NPI 1497700116 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
License✔ Licensed in CA · G80564
Definition
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
520 SUPERIOR AVE, Newport Beach, CA 92663
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Other Identifiers 1

Medicare UPING27340

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

Gary 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 ID1355434119
PECOS Enrollment IDI20070910000840
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.

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.
326 services201 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.
204 services124 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.
188 services188 patients
Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report 93000
An electrocardiogram (ECG) is a non-invasive test that records your heart's electrical activity. Using 12 leads attached to your body, it captures data to help identify heart conditions. A doctor interprets the results and provides a report.
184 services171 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.
50 services50 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.
44 services44 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 92663 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
$142.39 typical visit price
range $62.96 – $187.60
Typical copayment $35.59 (range $15.74 – $46.90)
Most-billed visit code 99204
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.

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.

83.01/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Individually scored
Quality72.9
Promoting Interoperability97
Improvement Activities40
Cost72.97

Reported Quality Measures

Breast Cancer Screening
49%198 patients2/55-star benchmark: 100%
Colorectal Cancer Screening
85%556 patients4/55-star benchmark: 100%
Controlling High Blood Pressure
81%426 patients4/55-star benchmark: 98%
Coronary Artery Disease (CAD): Antiplatelet Therapy
66%79 patients3/55-star benchmark: 100%
Diabetes: Hemoglobin A1c (HbA1c) Poor Control (>9%)
Lower rates are better for this measure.
15%72 patients4/55-star benchmark: 98%
Documentation of Current Medications in the Medical Record
91%2,281 patients2/55-star benchmark: 100%
Ischemic Vascular Disease (IVD) All or None Outcome Measure (Optimal Control)
13%87 patients
Preventive Care and Screening: Screening for High Blood Pressure and Follow-Up Documented
23%678 patients1/55-star benchmark: 100%
Provide Patients Electronic Access to Their Health Information
69%530 patients2/55-star benchmark: 100%
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 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
11 suppliers35 claims76 services$5.39 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
2 suppliers11 claims11 services$54.56 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.

DR. SEVITLANA SAFAEI MD
Internal Medicine
520 SUPERIOR AVE, STE 205
NEWPORT BEACH, CA 92663
Orange County (949) 650-2462
DR. KEVIN KHEDER M.D.
Internal Medicine (Interventional Cardiology)
520 SUPERIOR AVE
NEWPORT BEACH, CA 92663
Orange County (949) 478-7373
DR. RAJESH S BANKER M.D.
Internal Medicine (Clinical Cardiac Electrophysiology)
520 SUPERIOR AVE, SUITE 330
NEWPORT BEACH, CA 92663
Orange County (949) 478-7373
PRIVATE PHYSICIANS MEDICAL ASSOCIATES
Internal Medicine (Pulmonary Disease)
520 SUPERIOR AVE, SUITE 285
NEWPORT BEACH, CA 92663
Orange County (949) 566-8179
JERALD FREDRICK SIGALA M.D.
Internal Medicine (Nephrology)
520 SUPERIOR AVE, SUITE 340
NEWPORT BEACH, CA 92663
Orange County (949) 631-9215
LI SI ZENG PA-C
Physician Assistant (Medical)
520 SUPERIOR AVE, SUITE 270
NEWPORT BEACH, CA 92663
Orange County (949) 574-9300
ORANGE COUNTY VASCULAR SPECIALISTS, INC.
Surgery (Vascular Surgery)
520 SUPERIOR AVE, SUITE 370
NEWPORT BEACH, CA 92663
Orange County (949) 574-7176
MIKA MOORE AU.D.
Audiologist-Hearing Aid Fitter
520 SUPERIOR AVE, STE. 190
NEWPORT BEACH, CA 92663
Orange County (949) 548-0352

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 Gary Carlson's NPI number?

The NPI number for Gary Carlson is 1497700116. It was assigned to this individual provider in the NPPES registry on May 23, 2006.

Where is Gary Carlson located?

Gary Carlson practices at 520 Superior Ave Suite 220, Newport Beach, CA 92663. The listed phone number is (949) 722-3300.

What is Gary Carlson's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Is Gary Carlson enrolled in Medicare?

Yes. Gary 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.

When was this NPI record last updated?

The NPPES record for Gary Carlson was last updated on August 10, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 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.