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ELISE M S CARLSON M.D.
NPI 1811971260
Internal Medicine - Rheumatology in Milford, CT

Active since November 30, 2005PECOS EnrolledAccepts Medicare Assignment
73.56/100
CMS Quality Rating
326 WEST MAIN ST., UNIT 106, MILFORD, CT 06460(203) 878-4312(203) 878-4151 Get Directions Write a Review

NPPES record last updated: June 19, 2025. Verified against the NPPES registry weekly; last sync: November 01, 2026.

About Elise M S Carlson M.d. NPPES

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

ELISE M S CARLSON M.D. (NPI 1811971260) is an individual rheumatology provider in Milford, Connecticut, licensed in Connecticut (040968) and active in the NPI registry since November 2005. She is enrolled in Medicare PECOS and is a graduate of University Of Connecticut School Of Medicine (1997).

NPPES Registry Identity

NPI1811971260
Entity TypeIndividualFemale
Primary Taxonomy207RR0500X
Provider Legal NameELISE M S CARLSONCredential: M.D.
Location Address326 WEST MAIN ST., UNIT 106Milford, CT 06460
Mailing Address47 Clapboard Hill Rd, Ste 2Guilford, CT 06437 · (203) 789-2255 · Fax (203) 495-1888
Phone(203) 878-4312
Fax(203) 878-4151
Sole ProprietorNo
Medical School CMSUniversity Of Connecticut School Of MedicineGraduated 1997
Enumeration DateNovember 30, 2005
Last NPPES UpdateJune 19, 2025
✔ NPI 1811971260 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · RheumatologyAllopathic & Osteopathic Physicians
Taxonomy Code207RR0500X
License✔ Licensed in CT · 040968
Definition
An internist who treats diseases of joints, muscle, bones and tendons. This specialist diagnoses and treats arthritis, back pain, muscle strains, common athletic injuries and collagen diseases.
326 WEST MAIN ST., Milford, CT 06460
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Other Identifiers 1

Medicaid001409681CT

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield.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

Elise M S 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 ID6103877246
PECOS Enrollment IDI20050205000031
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 Elise Carlson reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Yale University
9.0 mi
Advanced Practice Midwife
100 CHURCH ST S STE 200, YALE SCHOOL OF NURSING
New Haven, CT 06519
  • Reassigned Medicare billing, Connecticut enrollment
  • 3,728 clinicians in this Medicare group
NPI 1124148887 (203) 737-5432
New Haven Rheumatology, P.C.
22 mi
Rheumatology
47 CLAPBOARD HILL RD., STE 2
Guilford, CT 06437
  • Reassigned Medicare billing, Connecticut enrollment
  • Medicare enrollment name: New Haven Rheumatology PC
  • 4 clinicians in this Medicare group
NPI 1598944746 (203) 789-2255

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 8

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.

Injection, golimumab, 1 mg, for intravenous use J1602
Golimumab is a medication given through an IV (a small tube in your vein). It helps to reduce inflammation and pain by blocking a protein in your body that causes inflammation. It's often used to treat conditions like rheumatoid arthritis, psoriatic arthritis, and ankylosing spondylitis.
13,100 services15 patients
Injection, abatacept, 10 mg (code may be used for medicare when drug administered under the direct supervision of a physician, not for use when drug is self administered) J0129
Abatacept is a medication administered via injection under a doctor's supervision. It's used to treat conditions like rheumatoid arthritis by moderating the immune system. This code applies when the doctor administers the drug, not for self-administration.
9,100 services23 patients
Infusion, normal saline solution, 250 cc J7050
An infusion of normal saline solution, 250 cc, involves administering a sterile saltwater solution into your body through a vein, usually in your arm. This helps to replenish fluids, maintain hydration, and balance electrolytes in your body.
324 services59 patients
Infusion into a vein for therapy, prevention, or diagnosis, 1 hour or less 96365
This is a procedure where a medical professional inserts a small tube into your vein to deliver medication, nutrients, or fluids directly into your bloodstream. This can be for treatment, prevention, or diagnosis. The process typically takes less than an hour.
322 services62 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.
311 services204 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.
296 services178 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 06460 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
$138.84 typical visit price
range $60.82 – $183.10
Typical copayment $34.71 (range $15.20 – $45.77)
Most-billed visit code 99204
Established Patient
$106.68 typical visit price
range $19.76 – $149.26
Typical copayment $26.67 (range $4.94 – $37.31)
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.

73.56/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality75.84
Promoting Interoperability74
Improvement Activities40
Cost51.43

Reported Quality Measures

Documentation of Current Medications in the Medical Record
Percentage of visits for patients aged 18 years and older for which the eligible professional or eligible clinician attests to documenting a list of current medications using all immediate resources available on the date of the encounter.
94%5,528 patients4/55-star benchmark: 100%
e-Prescribing
At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology.
93%1,215 patients4/55-star benchmark: 100%
Medication Reconciliation
The MIPS eligible clinician performs medication reconciliation for at least one transition of care in which the patient is transitioned into the care of the MIPS eligible clinician.
94%99 patients4/55-star benchmark: 100%
Patient-Specific Education
The MIPS eligible clinician must use clinically relevant information from CEHRT to identify patient-specific educational resources and provide access to those materials to at least one unique patient seen by the MIPS eligible clinician.
61%756 patients3/55-star benchmark: 100%
Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan
Percentage of patients aged 18 years and older with a BMI documented during the current encounter or during the previous twelve months AND with a BMI outside of normal parameters, a follow-up plan is documented during the encounter or during the previous…
62%2,532 patients3/55-star benchmark: 97%
Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention
Percentage of patients aged 18 years and older who were screened for tobacco use one or more times within 24 months AND who received tobacco cessation intervention if identified as a tobacco user
Patients screenedForUse: 62% · 2,229 patients
Patients tobacco: 60% · 2,229 patients
38%99 patients2/55-star benchmark: 98%
Provide Patient Access
At least one patient seen by the MIPS eligible clinician during the performance period is provided timely access to view online, download, and transmit to a third party their health information subject to the MIPS eligible clinician's discretion to withhold…
21%756 patients1/55-star benchmark: 100%
Rheumatoid Arthritis (RA): Assessment and Classification of Disease Prognosis
Percentage of patients aged 18 years and older with a diagnosis of rheumatoid arthritis (RA) who have an assessment and classification of disease prognosis at least once within 12 months
70%413 patients3/55-star benchmark: 100%
Screening for Osteoporosis for Women Aged 65-85 Years of Age
Percentage of female patients aged 65-85 years of age who ever had a central dual-energy X-ray absorptiometry (DXA) to check for osteoporosis
27%658 patients2/55-star benchmark: 97%
Secure Messaging
For at least one unique patient seen by the MIPS eligible clinician during the performance period, a secure message was sent using the electronic messaging function of CEHRT to the patient (or the patient-authorized representative), or in response to a secure…
1%756 patients1/55-star benchmark: 79%
Use of High-Risk Medications in the Elderly
Percentage of patients 65 years of age and older who were ordered high-risk medications. Two rates are submitted. 1) Percentage of patients who were ordered at least one high-risk medication.
Lower rates are better for this measure.
Patients 2+: 2% · 1,009 patients
3%1,009 patients4/55-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.

Other Providers at the Same Location NPPES

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

JULIE YIP D.O.
Internal Medicine (Rheumatology)
326 WEST MAIN ST., UNIT 106
MILFORD, CT 06460
South Central Connecticut Planning Region (203) 878-4312

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 Elise Carlson's NPI number?

The NPI number for Elise Carlson is 1811971260. It was assigned to this individual provider in the NPPES registry on November 30, 2005.

Where is Elise Carlson located?

Elise Carlson practices at 326 West Main St. Unit 106, Milford, CT 06460. The listed phone number is (203) 878-4312.

What is Elise Carlson's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Rheumatology, with taxonomy code 207RR0500X.

Is Elise Carlson enrolled in Medicare?

Yes. Elise 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 Elise Carlson's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Elise Carlson reassigns Medicare benefits to 2 organizations: Yale University (New Haven, CT) and New Haven Rheumatology, P.C. (Guilford, CT). 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 Elise Carlson's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Elise Carlson accept?

Health plans from Anthem Blue Cross and Blue Shield list Elise 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.

When was this NPI record last updated?

The NPPES record for Elise Carlson was last updated on June 19, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 months 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.