Richard A Carlson Jr. (NPI# 1740246735, PAC ID# 3072425537) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is INTERNAL MEDICINE.
| Nation Provider ID (NPI) | 1740246735 |
| PAC ID by PECOS | 3072425537 |
| Professional Enrollment ID | I20110622000566 |
| Full Name | Richard A Carlson Jr. |
| Organization Legal Name | SHERIDAN DRIVE MEDICAL GROUP LLP |
| Address |
1801 Grand Island Blvd Suite 3 Grand Island NY 14072-2249 |
| Phone Number | 7163324476 |
| Gender | M |
| Medical School | CREIGHTON UNIVERSITY SCHOOL OF MEDICINE |
| Graduation Year | 1978 |
| Primary Specialty | INTERNAL MEDICINE |
| Group Practice PAC ID | 8820900376 |
| Number of Group Practice Members | 7 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 330102 | KENMORE MERCY HOSPITAL |
| 330005 | KALEIDA HEALTH |
| 330078 | SISTERS OF CHARITY HOSPITAL |
| Address | Phone | Organization |
|---|---|---|
| 1801 Grand Island Blvd, Suite 3, Grand Island, NY 14072-2249 | 7163324476 | SHERIDAN DRIVE MEDICAL GROUP LLP |
| 1491 Sheridan Dr, Suite 100, Tonawanda, NY 14217-1234 | 7163324476 | SHERIDAN DRIVE MEDICAL GROUP LLP |
| Organization Legal Name | SHERIDAN DRIVE MEDICAL GROUP LLP |
| Physicians | 6 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Lauren Condrasky | Physician Assistant | Sheridan Drive Medical Group LLP | 1491 Sheridan Dr, Suite 100, Tonawanda, NY 14217-1234 |
| Kaylee L Mcrae | Physician Assistant | Sheridan Drive Medical Group LLP | 1491 Sheridan Dr, Suite 100, Tonawanda, NY 14217-1234 |
| Kariann M Womer | Physician Assistant | Sheridan Drive Medical Group LLP | 1491 Sheridan Dr, Suite 100, Tonawanda, NY 14217-1234 |
| Natalie F Trujillo-aguirre | Family Medicine | Sheridan Drive Medical Group LLP | 1801 Grand Island Blvd, Suite 3, Grand Island, NY 14072-2249 |
| Karen Hay Binis | Nurse Practitioner | Sheridan Drive Medical Group LLP | 1801 Grand Island Blvd, Suite 3, Grand Island, NY 14072-2249 |
| Street Address |
1801 GRAND ISLAND BLVD SUITE 3 |
| City | GRAND ISLAND |
| State | NY |
| Zip | 14072-2249 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Allison E Biondolillo | Physical Therapy | Grand Island Physical Therapy PC | 1801 Grand Island Blvd, Grand Island, NY 14072-2249 |
| Russell A Certo | Physical Therapy | Grand Island Physical Therapy PC | 1801 Grand Island Blvd, Grand Island, NY 14072-2249 |
| Natalie F Trujillo-aguirre | Family Medicine | Sheridan Drive Medical Group LLP | 1801 Grand Island Blvd, Suite 3, Grand Island, NY 14072-2249 |
| Karen Hay Binis | Nurse Practitioner | Sheridan Drive Medical Group LLP | 1801 Grand Island Blvd, Suite 3, Grand Island, NY 14072-2249 |
| Matthew R Kulpit | Physical Therapy | Grand Island Physical Therapy PC | 1801 Grand Island Blvd, Grand Island, NY 14072-2249 |
| Craig A Brattlie | Physical Therapy | Grand Island Physical Therapy PC | 1801 Grand Island Blvd, Grand Island, NY 14072-2249 |
| Matthew R Veronica | Physical Therapy | Grand Island Physical Therapy PC | 1801 Grand Island Blvd, Grand Island, NY 14072-2171 |
| Patricia A Richard | Physical Therapy | Grand Island Physical Therapy PC | 1801 Grand Island Blvd, Grand Island, NY 14072-2171 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Michael Joseph Calarco | Chiropractic | 101 Lang Blvd, Grand Island, NY 14072-1601 | |
| Syed E Haq | Cardiovascular Disease (cardiology) | 1826 Whitehaven Rd, Grand Island, NY 14072-1804 | |
| Megan L Lafave | Chiropractic | Grand Island Chiropractic PC | 2283 Grand Island Blvd, Grand Island, NY 14072-1819 |
| Jack Robert Saia | Chiropractic | Grand Island Chiropractic PC | 2283 Grand Island Blvd, Grand Island, NY 14072-1819 |
| Aaron Michael Boedecker | Chiropractic | Grand Island Chiropractic PC | 2283 Grand Island Blvd, Grand Island, NY 14072-1819 |
| Curtis M Gordon | Chiropractic | Grand Island Chiropractic PC | 2283 Grand Island Blvd, Grand Island, NY 14072-1819 |
| Warren A Marranca | Chiropractic | Grand Island Chiropractic PC | 2283 Grand Island Blvd, Grand Island, NY 14072-1819 |
| Nicholas A Ryan | Chiropractic | Grand Island Chiropractic PC | 2283 Grand Island Blvd, Grand Island, NY 14072-1819 |
| Thomas J Notaro | Chiropractic | Grand Island Chiropractic PC | 2283 Grand Island Blvd, Grand Island, NY 14072-1819 |
| William J Waldron | Optometry | Wjw Optometry PC | 2099 Grand Island Blvd, Suite A, Grand Island, NY 14072-2169 |
| Find all physicians in zip 14072 | |||
| City | GRAND ISLAND |
| Zip Code | 14072 |
| Specialty | INTERNAL MEDICINE |
| City + Specialty | GRAND ISLAND + INTERNAL MEDICINE |
Please comment or provide details below to improve the information on Richard A Carlson Jr..
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.