COURTNEY CARLSON (PA-C) – Physician Assistant, NPI 1053082867
Physician Assistant
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
5,032 PHYSICIAN ASSISTANT in OH
Provider Addresses for COURTNEY CARLSON (PA-C)
2277 MICHIGAN ST
SIDNEY, OH 453659077
Phone: (937) 492-1961
Type: Location
7701 SHARON DR APT 4H
MENTOR ON THE LAKE, OH 440602745
Phone: (440) 309-8325
Type: Mailing
1250 S WASHINGTON ST
VAN WERT, OH 458912551
Phone: (419) 238-2390
Type: Location
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: 2021-10-14
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
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20211014003090 | I | Physician Assistant | OH | TBD |
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.
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
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| J1100 | Injection, dexamethasone sodium phosphate, 1 mg | 113 | 13 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 85 | 85 | $0 |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 58 | 53 | $0 |
| 99203 | New patient office or other outpatient visit, 30-44 minutes | 31 | 31 | $0 |
| 87804 | Detection test by immunoassay with direct visual observation for influenza virus | 27 | 14 | $0 |
Insurance plans in this area (ZIP 45365)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| H O S P I T A L I S T | OH | |
| - | OH | |
| - | PA | |
| - | OH | |
| Physician Assistant | OH | |
| - | OH | |
| Nurse Practitioner | OH | |
| - | OH | |
| Nurse Practitioner | OH | |
| - | OH |
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