TODD J CARLSON (M.D.) – Family Medicine Physician, NPI 1164475554

TODD J CARLSON (M.D.) is a healthcare provider. based in Port townsend, Washington. specializing in FAMILY PRACTICE. They hold the professional credentials M.D.. They hold a License No. MD00038106 (WA). The NPI Number for TODD J CARLSON (M.D.) is 1164475554

Main info

Male
30 Years Of Experience
Accepts Medicare Assignment
Name
TODD J CARLSON (M.D.)
NPI
1164475554
Phone
(360) 379-8031
Address
915 SHERIDAN ST
Enumeration Date
18 May 2006
Last Update Date
1 September 2011

Doctor Profile

Medical School Name
UNIVERSITY OF MINNESOTA MEDICAL SCHOOL
Secondary Phone
3603853500
Graduation Year
1996 (30 years ago)
PAC ID
6800076514
Group Practice PAC ID
4789593708
Professional Enrollment ID
I20110214000392
Address ID
WA983682901PO1010XSTXX301
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience54
Completeness75
Years active:20State licenses:1Digital endpointsOther names

4,141 FAMILY PRACTICE in WA

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Provider Addresses for TODD J CARLSON (M.D.)

  • 915, Sheridan Street, Sea Breeze Mobile Home Park, Port Townsend, Jefferson County, Washington, 98368, United States

    SUITE B103

    PORT TOWNSEND, WA 983682931

    Phone: (360) 379-8031

    Fax: (360) 385-0418

    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: 2011-02-14

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

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

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20110214000392IFamily PracticeWATBD

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.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 98368)

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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: 4789593708View full group profile
NameSpecialtyState
-AK
-WA
Physician AssistantWA
Nurse PractitionerOR
Diagnostic RadiologyAK
Nurse PractitionerOR
Family PracticeWA
Nurse PractitionerWA
-WA
Physician AssistantWA

Reviews

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Frequently asked questions

Can I cross-check TODD J CARLSON (M.D.) using NPI 1164475554?
NPI 1164475554 belongs to TODD J CARLSON (M.D.); compare other details if you need extra assurance.
Is TODD J CARLSON (M.D.) still an active registrant?
TODD J CARLSON (M.D.) carries an active NPI according to the public dataset.
What kind of doctor is TODD J CARLSON (M.D.)?
TODD J CARLSON (M.D.) is associated with Family Medicine Physician in the directory — Clinical services aligned with this taxonomy classification.
Where in Washington is TODD J CARLSON (M.D.) registered?
Use Port Townsend, Washington as the headline location for TODD J CARLSON (M.D.) here.
Does TODD J CARLSON (M.D.) accept insurance?
Insurance participation is not part of the core NPI extract — call the plan or office to confirm.

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