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THERESA CARLSON AGACNP-BC
NPI 1861864860
Nurse Practitioner - Acute Care in Plano, TX

Active since October 29, 2015PECOS EnrolledAccepts Medicare Assignment
83.12/100
CMS Quality Rating
4708 ALLIANCE BLVD STE 600, PLANO, TX 75093(469) 467-0011(469) 467-4923 Get Directions Write a Review

NPPES record last updated: July 13, 2020. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jul 13, 2020, Feb 14, 2019 (2 updates tracked since 2019).

About Theresa Carlson Agacnp-bc NPPES

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

THERESA CARLSON AGACNP-BC (NPI 1861864860) is an individual acute care provider in Plano, Texas, licensed in Texas (AP129474) and active in the NPI registry since October 2015. She is enrolled in Medicare PECOS, is affiliated with Baylor Scott & White Medical Center Plano, and maintains a secondary practice location in Mckinney.

NPPES Registry Identity

NPI1861864860
Entity TypeIndividualFemale
Primary Taxonomy363LA2100X
Provider Legal NameTHERESA CARLSONCredential: AGACNP-BC
Location Address4708 ALLIANCE BLVD STE 600Plano, TX 75093-5368
Mailing Address4708 Alliance Blvd Ste 600Plano, TX 75093-5368 · (469) 467-0011 · Fax (469) 467-4923
Phone(469) 467-0011
Fax(469) 467-4923
Sole ProprietorNo
Medical School CMSOtherGraduated 2015
Enumeration DateOctober 29, 2015
Last NPPES UpdateJuly 13, 20202 updates tracked since enumeration
NPPES CertifiedJuly 13, 2020
✔ NPI 1861864860 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · Acute CarePhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LA2100X
License✔ Licensed in TX · AP129474
4708 ALLIANCE BLVD STE 600, Plano, TX 75093
Open in Google Maps ↗

Secondary Practice Location 1

Location 15236 W University Dr Ste 4200McKinney, TX 75071-8127 · Phone (214) 544-9590 · Fax (214) 544-9595

Other Identifiers 2

Medicaid360325002TX
Medicaid360325001TX

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arizona Complete Health, Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections and more.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

Theresa Carlson Agacnp-bc 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 ID8527358225
PECOS Enrollment IDI20160609000142
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 5

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.
138 services107 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.
52 services49 patients
New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204
This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.
46 services46 patients
Dialysis services, per day, less than full month service (20 years or older) 90970
Dialysis is a treatment that replicates some functions of healthy kidneys when they're not working properly. It helps to remove waste, salt, and excess water from your body and maintain a safe level of certain chemicals in your blood. This service, for patients aged 20 or older, is provided on a daily basis for less than a full month.
30 services15 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.
19 services14 patients

Hospital Affiliations CMS Care Compare 2

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

Baylor Scott & White Medical Center Plano

Acute Care Hospitals · Plano, TX
4/5 CMS rating
OwnershipVoluntary non-profit - Other
CMS Certification Number450890
Location4700 Alliance BoulevardPlano, TX 75093 · Collin County
Emergency services

Baylor Scott And White Medical Center Mckinney

Acute Care Hospitals · Mc Kinney, TX
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number670082
Location5252 West University DriveMc Kinney, TX 75071 · Collin County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 75093 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
$84.92 typical visit price
range $54.84 – $166.88
Typical copayment $21.23 (range $13.71 – $41.72)
Most-billed visit code 99203
Established Patient
$97.05 typical visit price
range $17.52 – $136.11
Typical copayment $24.26 (range $4.38 – $34.02)
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.

83.12/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality73.71
Promoting Interoperability92
Improvement Activities40
Cost60.04

Reported Quality Measures

Colorectal Cancer Screening
Percentage of adults 50-75 years of age who had appropriate screening for colorectal cancer
2%92 patients1/55-star benchmark: 85%
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.
100%61 patients5/55-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.
36%190 patients2/55-star benchmark: 97%
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…
21%182 patients1/55-star benchmark: 97%
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…
66%190 patients3/55-star benchmark: 100%
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…
7%190 patients1/55-star benchmark: 89%
View, Download, or Transmit (VDT)
At least one patient seen by the MIPS eligible clinician during the performance period (or patient-authorized representative) views, downloads or transmits their health information to a third party during the performance period.
24%190 patients
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 3

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

JANETTE GASAWAY APRN, NP-C
Nurse Practitioner (Family)
4708 ALLIANCE BLVD STE 600
PLANO, TX 75093
Collin County (469) 467-0011
SCOTT A BIEDERMANN MD
Internal Medicine (Nephrology)
4708 ALLIANCE BLVD STE 600
PLANO, TX 75093
Collin County (469) 467-0011
KYA KRAUSE
Nurse Practitioner (Family)
4708 ALLIANCE BLVD STE 600
PLANO, TX 75093
Collin County (469) 467-0011

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 Theresa Carlson's NPI number?

The NPI number for Theresa Carlson is 1861864860. It was assigned to this individual provider in the NPPES registry on October 29, 2015.

Where is Theresa Carlson located?

Theresa Carlson practices at 4708 Alliance Blvd Ste 600, Plano, TX 75093. The listed phone number is (469) 467-0011.

What is Theresa Carlson's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Acute Care, with taxonomy code 363LA2100X.

Is Theresa Carlson enrolled in Medicare?

Yes. Theresa 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 Theresa Carlson accept?

Health plans from Ambetter Health, Ambetter from Arizona Complete Health, Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections and Ambetter from Superior HealthPlan and 4 other insurers list Theresa 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 Theresa Carlson affiliated with any hospitals?

According to CMS data, Theresa Carlson is affiliated with Baylor Scott & White Medical Center Plano and Baylor Scott And White Medical Center Mckinney.

When was this NPI record last updated?

The NPPES record for Theresa Carlson was last updated on July 13, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.