MARK O. CARLSON M.D.
NPI 1609837368
Internal Medicine in Sioux City, IA

Q: What is Mark Carlson's NPI number?

The NPI number for Mark Carlson is 1609837368. It was assigned to this individual provider in the NPPES registry on March 31, 2006.

Q: What is Mark Carlson's specialty?

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

Q: When was this NPI record last updated?

The NPPES record for Mark Carlson was last updated on November 22, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 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 March 31, 2006PECOS EnrolledAccepts Medicare Assignment

1605 DOUGLAS ST, SIOUX CITY, IA 51105(712) 234-1005(712) 234-0015 Get Directions Write a Review

NPPES record last updated: November 22, 2012. Verified against the NPPES registry weekly; last sync: October 18, 2026.

On this page

About Mark O. Carlson M.d. NPPES

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

MARK O. CARLSON M.D. (NPI 1609837368) is an individual internal medicine provider in Sioux City, Iowa, licensed in Iowa (27247) and active in the NPI registry since March 2006. He is enrolled in Medicare PECOS, is affiliated with St Lukes Regional Medical Center, and is a graduate of University Of Minnesota Medical School (1986).

NPPES Registry Identity

NPI1609837368

Entity TypeIndividualMale

Primary Taxonomy207R00000X

Provider Legal NameMARK O. CARLSONCredential: M.D.

Location Address1605 DOUGLAS STSioux City, IA 51105-1109

Mailing Address1605 Douglas StSioux City, IA 51105-1109 · (712) 234-1005 · Fax (712) 234-0015

Phone(712) 234-1005

Fax(712) 234-0015

Sole ProprietorNo

Medical School CMSUniversity Of Minnesota Medical SchoolGraduated 1986

Enumeration DateMarch 31, 2006

Last NPPES UpdateNovember 22, 2012

✔ NPI 1609837368 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207R00000X

License✔ Licensed in IA · 27247

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.

1605 DOUGLAS ST, Sioux City, IA 51105

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Other Identifiers 5

Medicare UPINE16782IA

OtherIB1201001IA · Medicare Ptan

Medicaid2059956IA

Medicaid6004143SD

Medicaid10025457800NE

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from NH Healthy Families, Ambetter from Sunflower Health Plan, Ambetter Health and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Mark O. 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 ID4688673908

PECOS Enrollment IDI20061215000009

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.

Medicare Billing Reassignment

Medicare enrollment records show Mark Carlson reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Siouxland Adult Medicine, PLLC

0.8 mi

Specialist

2800 PIERCE ST, SUITE 410
Sioux City, IA 51104

Reassigned Medicare billing, Iowa enrollment
6 clinicians in this Medicare group

NPI 1295991677 (712) 234-1005

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims 25

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.

521 services155 patients

Insertion of needle into vein for collection of blood sample 36415

This procedure involves inserting a small needle into a vein, typically in your arm, to collect a blood sample. It's a quick and simple process to help diagnose or monitor health conditions. You may feel a small prick, but discomfort is minimal.

381 services148 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.

133 services112 patients

Annual alcohol misuse screening, 5 to 15 minutes G0442

An annual alcohol misuse screening is a 15-minute check-up to assess your drinking habits. It helps identify if you're consuming alcohol in a way that could harm your health. This is not a judgment, but a tool to promote your wellbeing.

130 services130 patients

Injection, ceftriaxone sodium, per 250 mg J0696

Ceftriaxone sodium is an antibiotic injection used to treat a variety of bacterial infections. Each injection contains 250 mg of the medicine. It works by stopping the growth of bacteria in your body.

128 services14 patients

Advance care planning, first 30 minutes 99497

Advance care planning is a process where you discuss your healthcare preferences with your doctor. This conversation, lasting up to 30 minutes, helps ensure your wishes are respected if you're unable to communicate them in the future. It's about your care, your way.

126 services123 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.

124 services124 patients

Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more 99215

This service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.

120 services105 patients

Annual, face-to-face intensive behavioral therapy for cardiovascular disease, individual, 15 minutes G0446

This is a yearly, personal consultation focused on behaviors affecting heart health. It lasts 15 minutes and may cover topics like diet, exercise, and stress management. It's about learning healthy habits to protect your heart.

118 services118 patients

Test to measure rate of airflow 94375

This test, known as spirometry, measures how much air you can breathe in and out, and how quickly you can do so. It helps assess your lung function and can be used to diagnose or monitor conditions like asthma or COPD.

113 services106 patients

Annual depression screening, 5 to 15 minutes G0444

An annual depression screening is a short, routine evaluation to check for signs of depression. It involves answering a series of questions about your feelings, thoughts, and behaviors. The process takes about 15 minutes and helps detect depression early for better management.

106 services106 patients

Test for balance and posture 92548

A balance and posture test assesses your ability to maintain steady positioning and coordination. It involves simple tasks like standing on one foot or walking in a straight line. This helps identify any issues with your balance system, which can affect daily activities.

102 services100 patients

Ultrasound study of arm and leg arteries 93922

An ultrasound study of arm and leg arteries is a non-invasive procedure that uses sound waves to create images of your arteries. It helps in checking blood flow, identifying blockages, or detecting other abnormalities in your arteries.

100 services100 patients

Exercise or drug-induced heart stress test with electrocardiogram (ecg) with supervision and review by physician 93015

An exercise or drug-induced heart stress test with ECG is a procedure performed by a doctor to assess how your heart responds to exertion. It involves monitoring your heart's electrical activity while you exercise or after medication is given to mimic exercise effects.

71 services71 patients

Face-to-face behavioral counseling for obesity, 15 minutes G0447

This is a 15-minute consultation where a healthcare professional discusses your eating habits, physical activity, and goals to help manage your weight. The aim is to provide personalized strategies to promote a healthier lifestyle and combat obesity.

70 services41 patients

Injection of drug or substance under skin or into muscle 96372

This procedure involves administering medication directly under the skin or into a muscle. A small needle is used to inject the drug, allowing it to be absorbed quickly into the bloodstream. It's a common method for delivering a variety of medications.

40 services15 patients

Detection test by immunoassay with direct visual observation for influenza virus 87804

This is a test that identifies the influenza virus in your body. It works by using an immunoassay, a method that detects the presence of the virus through an immune response. The results are directly observable, making it a quick and efficient way to diagnose flu.

37 services19 patients

Automated urinalysis test 81003

An automated urinalysis test is a routine examination that checks your urine for various substances. It can help identify potential health issues such as kidney problems or diabetes. The test uses a machine to analyze a small urine sample, providing quick and accurate results.

36 services34 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.

36 services28 patients

Detection test by immunoassay technique for severe acute respiratory syndrome coronavirus 87426

An immunoassay test for severe acute respiratory syndrome coronavirus is a diagnostic tool. It uses your body's immune response to detect the presence of the virus. It involves taking a sample, usually from your nose or throat, which is then analyzed in a lab for signs of the virus.

22 services21 patients

Detection test by immunoassay with direct visual observation for streptococcus, group a (strep) 87880

A detection test by immunoassay for Group A Strep is a quick procedure to identify a bacterial infection in your throat. It involves taking a throat swab and applying it to a test strip, which changes color if Strep bacteria are present.

22 services17 patients

Transitional care management services for problem of high complexity 99496

Transitional care management services are designed to ensure a smooth transition from a hospital to home or another care setting for patients with complex health issues. These services include medication management, patient education, and coordination with healthcare providers.

21 services15 patients

Detection test by immunoassay with direct visual observation for respiratory syncytial virus 87807

This is a test to identify the respiratory syncytial virus, a common cause of lung and respiratory tract infections. It uses immunoassay, a method that detects the virus through a reaction between the virus and specific antibodies. The result is visually observed.

18 services17 patients

Dxa bone density measurement of hip, pelvis, spine 77080

A DXA bone density measurement is a simple, quick, and non-invasive procedure that assesses the strength of your bones. This test uses X-rays to measure the amount of minerals, mainly calcium, in the hip, pelvis, and spine. It helps in early detection of osteoporosis or other bone diseases.

17 services17 patients

Removal of impacted ear wax 69210

Impacted ear wax removal is a safe procedure to clear blockages in the ear canal caused by hardened ear wax. A healthcare professional uses specialized tools or a gentle irrigation method to loosen and remove the wax, improving hearing and alleviating discomfort.

16 services15 patients

Hospital Affiliations CMS Care Compare 2

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

St Lukes Regional Medical Center

Acute Care Hospitals · Sioux City, IA

2/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number160146

Location2720 Stone Park BoulevardSioux City, IA 51104 · Woodbury County

Emergency services Birthing friendly

Floyd Valley Healthcare

Critical Access Hospitals · Le Mars, IA

OwnershipGovernment - Local

CMS Certification Number161368

Location714 Lincoln St NELe Mars, IA 51031 · Plymouth County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 51105 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

$122.23 typical visit price

range $52.96 – $161.40

Typical copayment $30.55 (range $13.24 – $40.35)

Most-billed visit code 99204

Established Patient

$94.05 typical visit price

range $16.91 – $131.98

Typical copayment $23.51 (range $4.22 – $32.99)

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 15

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 suppliers19 claims47 services$6.19 avg. paid by Medicare

Ostomy skin barrier, solid 4 x 4 or equivalent, extended wear, without built-in convexity, each A4385

DME-Orthotic Devices · category DF010N

1 supplier17 claims170 services$4.63 avg. paid by Medicare

Ostomy pouch, drainable; for use on barrier with flange (2 piece system), each A5063

DME-Orthotic Devices · category DF010N

1 supplier18 claims270 services$2.36 avg. paid by Medicare

Full face mask used with positive airway pressure device, each A7030

DME-Other DME · category DE001N

3 suppliers15 claims15 services$100.03 avg. paid by Medicare

Face mask interface, replacement for full face mask, each A7031

DME-Other DME · category DE001N

3 suppliers17 claims43 services$36.07 avg. paid by Medicare

Headgear used with positive airway pressure device A7035

DME-Other DME · category DE001N

3 suppliers19 claims19 services$20.65 avg. paid by Medicare

Tubing used with positive airway pressure device A7037

DME-Other DME · category DE001N

3 suppliers24 claims24 services$15.58 avg. paid by Medicare

Filter, disposable, used with positive airway pressure device A7038

DME-Other DME · category DE001N

3 suppliers22 claims132 services$2.55 avg. paid by Medicare

Water chamber for humidifier, used with positive airway pressure device, replacement, each A7046

DME-Other DME · category DE001N

3 suppliers14 claims14 services$12.90 avg. paid by Medicare

Enteral formula, nutritionally complete, calorically dense (equal to or greater than 1.5 kcal/ml) with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit B4152

Other-Enteral and Parenteral · category OB006N

1 supplier13 claims5,692 services$0.31 avg. paid by Medicare

Enteral formula, nutritionally complete, for special metabolic needs, excludes inherited disease of metabolism, includes altered composition of proteins, fats, carbohydrates, vitamins and/or minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit B4154

Other-Enteral and Parenteral · category OB006N

1 supplier11 claims2,268 services$0.69 avg. paid by Medicare

Continuous positive airway pressure (cpap) device E0601

DME-Other DME · category DE001N

3 suppliers42 claims42 services$37.62 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 suppliers30 claims30 services$82.62 avg. paid by Medicare

Portable oxygen concentrator, rental E1392

DME-Oxygen and Supplies · category DC002N

1 supplier17 claims17 services$30.82 avg. paid by Medicare

Supply allowance for therapeutic continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service K0553

DME-Other DME · category DE017N

4 suppliers33 claims33 services$179.19 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

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

DAWN M BRICKER FNP

Nurse Practitioner (Family)

1605 DOUGLAS ST
SIOUX CITY, IA 51105

Woodbury County (712) 234-1005

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 Mark Carlson's NPI number?

The NPI number for Mark Carlson is 1609837368. It was assigned to this individual provider in the NPPES registry on March 31, 2006.

Where is Mark Carlson located?

Mark Carlson practices at 1605 Douglas St, Sioux City, IA 51105. The listed phone number is (712) 234-1005.

What is Mark Carlson's specialty?

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

Is Mark Carlson enrolled in Medicare?

Yes. Mark 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.

Which organization bills Medicare for Mark Carlson's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Mark Carlson reassigns Medicare benefits to Siouxland Adult Medicine, PLLC (Sioux City, IA). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Mark Carlson's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Mark Carlson accept?

Health plans from Ambetter Health, Ambetter Health of Delaware, Ambetter from NH Healthy Families, Ambetter from Sunflower Health Plan and Avera Health Plans and 3 other insurers list Mark 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 Mark Carlson affiliated with any hospitals?

According to CMS data, Mark Carlson is affiliated with St Lukes Regional Medical Center and Floyd Valley Healthcare.

When was this NPI record last updated?

The NPPES record for Mark Carlson was last updated on November 22, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 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.