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DR. MARK A CARLSSON M.D.
NPI 1962443614
Family Medicine in Butler, PA

Active since June 10, 2006PECOS EnrolledAccepts Medicare Assignment
1 HOSPITAL WAY, BUTLER, PA 16001(724) 285-0823(724) 285-0879 Get Directions Write a Review

NPPES record last updated: October 9, 2018. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Oct 9, 2018, Feb 10, 2017 (2 updates tracked since 2017).

About Dr. Mark A Carlsson M.d. NPPES

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

DR. MARK A CARLSSON M.D. (NPI 1962443614) is an individual family medicine provider in Butler, Pennsylvania, licensed in Pennsylvania (029584E) and active in the NPI registry since June 2006. He is enrolled in Medicare PECOS, is affiliated with Butler Memorial Hospital, and is a graduate of Hahneman Medical College Of The Pacific (1982).

NPPES Registry Identity

NPI1962443614
Entity TypeIndividualMale
Primary Taxonomy207Q00000X
Provider Legal NameDR. MARK A CARLSSONCredential: M.D.
Location Address1 HOSPITAL WAYButler, PA 16001-4670
Mailing AddressPo Box 1549Butler, PA 16003-1549 · (724) 285-0823 · Fax (724) 285-0879
Phone(724) 285-0823
Fax(724) 285-0879
Sole ProprietorNo
Medical School CMSHahneman Medical College Of The PacificGraduated 1982
Enumeration DateJune 10, 2006
Last NPPES UpdateOctober 9, 20182 updates tracked since enumeration
✔ NPI 1962443614 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in PA · 029584E
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
1 HOSPITAL WAY, Butler, PA 16001
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Other Identifiers 1

Medicaid0014914040002PA

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter Health, Ambetter Health of Delaware.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

Dr. Mark A Carlsson 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 ID7315847431
PECOS Enrollment IDI20100406000587
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 4

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.

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes 99232
Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.
158 services69 patients
Hospital discharge day management, more than 30 minutes 99239
Hospital discharge day management over 30 minutes involves a detailed process to ensure a smooth transition from hospital to home. It includes final examinations, discussion of your hospital stay, post-discharge instructions, and coordinating follow-up care.
54 services51 patients
Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes 99233
Follow-up hospital inpatient care per day typically involves a 35-minute check-up by your healthcare provider. This service includes monitoring your health progress, adjusting your treatment plan if needed, and answering any questions you may have about your condition or care.
32 services19 patients
Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes 99222
Initial hospital inpatient care is a service where a healthcare provider spends about 50 minutes per day overseeing your care while you're admitted in the hospital. This includes reviewing your health status, planning your treatment, and ensuring your safety and comfort.
30 services30 patients

Hospital Affiliations CMS Care Compare

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

Butler Memorial Hospital

Acute Care Hospitals · Butler, PA
2/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number390168
LocationOne Hospital WayButler, PA 16001 · Butler County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 16001 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
$84.88 typical visit price
range $54.64 – $166.87
Typical copayment $21.22 (range $13.66 – $41.71)
Most-billed visit code 99203
Established Patient
$96.82 typical visit price
range $17.33 – $135.84
Typical copayment $24.20 (range $4.33 – $33.96)
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

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress E0260
DME-Hospital Beds · category DB000N
1 supplier14 claims14 services$44.28 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.

UZMA SHAHZAD MD
Internal Medicine (Infectious Disease)
1 HOSPITAL WAY
BUTLER, PA 16001
Butler County (724) 284-4309
TRICIA LEIGHT CRNP
Nurse Practitioner
1 HOSPITAL WAY
BUTLER, PA 16001
Butler County (724) 283-6666
MELISSE S MASER RN, CRNP
Nurse Practitioner (Family)
1 HOSPITAL WAY
BUTLER, PA 16001
Butler County (724) 284-4699
DALE ORDEAN CRNP
Family Medicine
1 HOSPITAL WAY, FIRST FLOOR
BUTLER, PA 16001
Butler County (724) 431-0550
RICHARD THOMAS FILIAGGI DO
Pediatrics
1 HOSPITAL WAY
BUTLER, PA 16001
Butler County (724) 285-0823
GABRIEL PATRICK ARMANDO PA-C
Physician Assistant
1 HOSPITAL WAY
BUTLER, PA 16001
Butler County (724) 283-6666
DR. STEPHANIE L CLARK M.D.
Internal Medicine
1 HOSPITAL WAY
BUTLER, PA 16001
Butler County (724) 285-0823
MADISON ANN BIGLEY PA-C
Physician Assistant (Medical)
1 HOSPITAL WAY
BUTLER, PA 16001
Butler County (724) 284-4550

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 Carlsson's NPI number?

The NPI number for Mark Carlsson is 1962443614. It was assigned to this individual provider in the NPPES registry on June 10, 2006.

Where is Mark Carlsson located?

Mark Carlsson practices at 1 Hospital Way, Butler, PA 16001. The listed phone number is (724) 285-0823.

What is Mark Carlsson's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Mark Carlsson enrolled in Medicare?

Yes. Mark Carlsson 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 Mark Carlsson accept?

Health plans from Ambetter Health, Ambetter Health of Delaware and Ambetter from Buckeye Health Plan list Mark Carlsson 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 Carlsson affiliated with any hospitals?

According to CMS data, Mark Carlsson is affiliated with Butler Memorial Hospital.

When was this NPI record last updated?

The NPPES record for Mark Carlsson was last updated on October 9, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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.