CHRISTIAN LACELLE CARLSON (MD) – Diagnostic Radiology Physician, NPI 1669462958
Diagnostic Radiology Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
2,563 DIAGNOSTIC RADIOLOGY in PA
Provider Addresses for CHRISTIAN LACELLE CARLSON (MD)
PO BOX 27128
SALT LAKE CITY, UT 841270128
Phone: (801) 662-1800
Type: Mailing
160 E ERIE AVE
PHILADELPHIA, PA 191341011
Phone: (215) 427-5234
Type: Location
Eagle Canyon, San Antonio, Bexar County, Texas, 78247, United States
SAN ANTONIO, TX 782474459
Phone: (210) 495-3174
Type: Mailing
3851 ROGER BROOKE DR
MCHE-QD (CREDENTIALS)
FORT SAM HOUSTON, TX 782344501
Phone: (210) 916-2460
Type: Location
100 N Mario Capecchi Dr
Salt Lake City, UT 841131103
Phone: (801) 662-1800
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: 2022-11-14
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 2 Medicare enrollment records; no due dates published yet.
Enrollment records
2
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 |
|---|---|---|---|---|
| I20210513001808 | I | Diagnostic Radiology | UT | TBD |
| I20221114001319 | I | Diagnostic Radiology | PA | 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.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 84127)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Emergency Medicine | UT | |
| - | OR | |
| Family Practice | UT | |
| H O S P I T A L I S T | UT | |
| O B S T E T R I C S/ G Y N E C O L O G Y | UT | |
| - | UT | |
| - | UT | |
| - | UT | |
| Family Practice | UT | |
| - | UT |
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