DR. DUSTIN PAUL CARLSON (D.C.) – Chiropractor, NPI 1417045048

DR. DUSTIN PAUL CARLSON (D.C.) is a healthcare provider. based in White bear lake, Minnesota. specializing in CHIROPRACTIC. They hold the professional credentials D.C.. They hold a License No. 4394 (MN). The NPI Number for DR. DUSTIN PAUL CARLSON (D.C.) is 1417045048

Main info

Male
Sole Proprietor
23 Years Of Experience
Accepts Medicare Assignment
Name
DR. DUSTIN PAUL CARLSON (D.C.)
NPI
1417045048
Phone
(651) 762-8040
Address
4717 CLARK AVE
Enumeration Date
10 October 2006
Last Update Date
22 June 2016

Doctor Profile

Medical School Name
LOGAN COLLEGE OF CHIROPRACTIC
Secondary Phone
6517628040
Graduation Year
2003 (23 years ago)
PAC ID
3476639550
Group Practice PAC ID
0749366821
Professional Enrollment ID
I20080331000030
Address ID
MN551103207WH2130XSTXX300
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience52
Completeness75
Years active:19State licenses:1Digital endpointsOther names

1,642 CHIROPRACTIC in MN

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Provider Addresses for DR. DUSTIN PAUL CARLSON (D.C.)

  • 4717, Clark Avenue, White Bear Lake, Ramsey County, Minnesota, 55110, United States

    WHITE BEAR LAKE, MN 551103221

    Phone: (651) 762-8040

    Fax: (651) 762-8070

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2008-03-31

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20080331000030IChiropracticMNTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
98941Chiropractic manipulative treatment, 3-4 spinal regions1,23099$0
View full utilization report →

Insurance plans in this area (ZIP 55110)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 0749366821View full group profile
NameSpecialtyState
C H I R O P R A C T I CIN
C H I R O P R A C T I CMN
C H I R O P R A C T I CMN
C H I R O P R A C T I CMN

Reviews

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Frequently asked questions

Is DR. DUSTIN PAUL CARLSON (D.C.) listed with a National Provider Identifier?
Yes — DR. DUSTIN PAUL CARLSON (D.C.) has NPI 1417045048 on file in the registry.
Is there an active status for DR. DUSTIN PAUL CARLSON (D.C.)?
For scheduling context, DR. DUSTIN PAUL CARLSON (D.C.) is shown as active in the registry.
What kind of doctor is DR. DUSTIN PAUL CARLSON (D.C.)?
DR. DUSTIN PAUL CARLSON (D.C.) is associated with Chiropractor in the directory — Clinical services aligned with this taxonomy classification.
What practice footprint exists for DR. DUSTIN PAUL CARLSON (D.C.)?
Travel planning: use White Bear Lake, Minnesota as the reference point for DR. DUSTIN PAUL CARLSON (D.C.), then confirm.
Does inactive status remove historical data?
Historical rows can remain visible after status changes — read the dates carefully.

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