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ANDREA GALE CARLSON MD
NPI 1750382974
Emergency Medicine in Downers Grove, IL

Active since August 10, 2005PECOS EnrolledAccepts Medicare Assignment
3815 HIGHLAND AVE, ADVOCATE GOOD SAMARITAN HOSPITAL, DOWNERS GROVE, IL 60515(630) 275-5900(630) 734-1560 Get Directions Write a Review

NPPES record last updated: December 21, 2021. Verified against the NPPES registry weekly; last sync: November 08, 2026.

About Andrea Gale Carlson Md NPPES

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

ANDREA GALE CARLSON MD (NPI 1750382974) is an individual emergency medicine provider in Downers Grove, Illinois, licensed in Illinois (036-100002) and active in the NPI registry since August 2005. She is enrolled in Medicare PECOS, is affiliated with Advocate Christ Hospital & Medical Center, and is a graduate of University Of Illinois College Of Med (chi/peor/rock/chm-urb) (1996).

NPPES Registry Identity

NPI1750382974
Entity TypeIndividualFemale
Primary Taxonomy207P00000X
Provider Legal NameANDREA GALE CARLSONCredential: MD
Location Address3815 HIGHLAND AVE, ADVOCATE GOOD SAMARITAN HOSPITALDowners Grove, IL 60515-1500
Mailing AddressPo Box 88495, Dept AChicago, IL 60680-1495 · (630) 734-0200 · Fax (630) 734-1560
Phone(630) 275-5900
Fax(630) 734-1560
Sole ProprietorNo
Medical School CMSUniversity Of Illinois College Of Med (chi/peor/rock/chm-urb)Graduated 1996
Enumeration DateAugust 10, 2005
Last NPPES UpdateDecember 21, 2021
NPPES CertifiedDecember 21, 2021
✔ NPI 1750382974 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyEmergency MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207P00000X
License✔ Licensed in IL · 036-100002
Definition
An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury.
3815 HIGHLAND AVE, Downers Grove, IL 60515
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Other Identifiers 1

Medicaid036100002IL

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

Andrea Gale 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 ID6103890074
PECOS Enrollment IDI20040825000925
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 Reassignments

2

Medicare enrollment records show Andrea Carlson reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Dupage Emergency Physicians Ltd
Same address
Emergency Medicine
3815 HIGHLAND AVE
Downers Grove, IL 60515
  • Reassigned Medicare billing, Illinois enrollment
  • 36 clinicians in this Medicare group
NPI 1255323481 (630) 275-5900
Advocate Health And Hospitals Corporation
0.1 mi
Cardiovascular Disease
3825 HIGHLAND AVE, TOWER 2 SUITE 400
Downers Grove, IL 60515
  • Reassigned Medicare billing, Illinois enrollment
  • 4,870 clinicians in this Medicare group
NPI 1285903849 (630) 719-4799

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 3

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.

Emergency department visit with high level of medical decision making 99285
An emergency department visit for severe conditions is when you urgently seek medical help due to serious health issues. These could be severe injuries, breathing problems, unbearable pain, or sudden severe illness. Doctors and nurses will provide immediate care to stabilize your condition.
88 services88 patients
Emergency department visit with moderate level of medical decision making 99284
An emergency department visit for a high-severity issue means you're experiencing a serious health problem that needs immediate attention. This could be a severe injury, serious illness, or life-threatening condition. Medical professionals will provide urgent care to stabilize your condition.
49 services49 patients
Critical care, first 30-74 minutes 99291
Critical care involves immediate and constant attention by a team of specially-trained health professionals. It's for patients with life-threatening conditions, requiring first 30-74 minutes of intense monitoring and treatment.
19 services19 patients

Hospital Affiliations CMS Care Compare

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

Advocate Christ Hospital & Medical Center

Acute Care Hospitals · Oak Lawn, IL
2/5 CMS rating
OwnershipVoluntary non-profit - Church
CMS Certification Number140208
Location4440 W 95th StreetOak Lawn, IL 60453 · Cook County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 60515 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
$93.02 typical visit price
range $59.81 – $181.38
Typical copayment $23.25 (range $14.95 – $45.34)
Most-billed visit code 99203
Established Patient
$105.07 typical visit price
range $19.15 – $147.12
Typical copayment $26.26 (range $4.78 – $36.78)
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.

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.

STEPHANIE WOLFF PA-C
Physician Assistant
3815 HIGHLAND AVE
DOWNERS GROVE, IL 60515
Dupage County (630) 275-5900
ABIGAIL MAZUREK
Physical Therapist
3815 HIGHLAND AVE
DOWNERS GROVE, IL 60515
Dupage County (630) 275-5900
DR. MICHAEL J IWANICKI D.O.
Surgery
3815 HIGHLAND AVE, TOWER 2, SUITE 107
DOWNERS GROVE, IL 60515
Dupage County (630) 275-7800
TRAUMA AND SURGICAL SPECIALISTS OF DUPAGE, LLC
Surgery
3815 HIGHLAND AVE, TOWER 2, SUITE 107
DOWNERS GROVE, IL 60515
Dupage County (630) 275-7800
DR. JUSTIN GRIFFITH MILLER M.D.
Thoracic Surgery (Cardiothoracic Vascular Surgery)
3815 HIGHLAND AVE
DOWNERS GROVE, IL 60515
Dupage County (630) 324-7913
ZACHARY JOHN BASTIAN M.D.
Anesthesiology
3815 HIGHLAND AVE
DOWNERS GROVE, IL 60515
Dupage County (630) 275-5900
MANISA BAKER APN
Clinical Nurse Specialist (Acute Care)
3815 HIGHLAND AVE
DOWNERS GROVE, IL 60515
Dupage County (630) 275-5900
MARY SUE DAILEY APRN
Clinical Nurse Specialist (Adult Health)
3815 HIGHLAND AVE
DOWNERS GROVE, IL 60515
Dupage County (630) 275-5900

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 Andrea Carlson's NPI number?

The NPI number for Andrea Carlson is 1750382974. It was assigned to this individual provider in the NPPES registry on August 10, 2005.

Where is Andrea Carlson located?

Andrea Carlson practices at 3815 Highland Ave Advocate Good Samaritan Hospital, Downers Grove, IL 60515. The listed phone number is (630) 275-5900.

What is Andrea Carlson's specialty?

The primary specialty registered for this NPI is Emergency Medicine with taxonomy code 207P00000X.

Is Andrea Carlson enrolled in Medicare?

Yes. Andrea 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 organizations bill Medicare for Andrea Carlson's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Andrea Carlson reassigns Medicare benefits to 2 organizations: Dupage Emergency Physicians Ltd (Downers Grove, IL) and Advocate Health And Hospitals Corporation (Downers Grove, IL). Each 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 Andrea Carlson's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

Is Andrea Carlson affiliated with any hospitals?

According to CMS data, Andrea Carlson is affiliated with Advocate Christ Hospital & Medical Center.

When was this NPI record last updated?

The NPPES record for Andrea Carlson was last updated on December 21, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.