Active NPI
Douglas Steven Larsen, PA-C
- Physician Assistant
- Red Wing, MN
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 12317
- Practice address
- 701 Hewitt Blvd
Red Wing, MN 55066 - Phone
- (651) 267-5000
- NPI assigned
- Jul 7, 2010
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | |||
| Medical Physician Assistant | 363AM0700X | 3095 | WI | |
| Physician Assistant | 363A00000X | 12317 | MN | Primary |
Addresses
Primary practice location
701 Hewitt Blvd
Red Wing, MN 55066
Mailing address
701 Hewitt Blvd
Red Wing, MN 55066-2848
Phone (651) 267-5000
Other practice location 1
1836 South Ave
LA Crosse, WI 54601-5429
Phone (608) 782-7300
Other practice location 2
1836 South Ave
LA Crosse, WI 54601-5429
Phone (608) 782-7300
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | dlarsen88427@ehrdirect.mayoclinicmsg.org |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MN
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- University of Iowa, RJ & L Carver College of Medicine, 2010
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Mayo Clinic Health System-Southwest Minnesota Region
Practice addresses (Care Compare)
1025 Marsh St
Mankato, MN 56001-4752
Phone (507) 625-4031
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3095 | WI | MD | Psychologist |
Practice roles
Locations
404 W Fountain St
Albert Lea, MN 56007
Phone (507) 377-6285
1000 1st Dr NW
Austin, MN 55912
Phone (507) 433-7351
32021 County 24 Blvd
Cannon Falls, MN 55009
Phone (507) 263-6000
800 Medical Center Dr
Fairmont, MN 56031
Phone (507) 238-8100
500 W Grant St
Lake City, MN 55041
Phone (651) 345-3321
1025 Marsh St
Mankato, MN 56001
Phone (507) 345-2623
301 2nd St NE
New Prague, MN 56071
Phone (952) 758-4431
701 Hewitt Blvd
Red Wing, MN 55066
Phone (507) 377-6285
200 1st St SW
Rochester, MN 55905
Phone (507) 266-4850
1101 Moulton and Parsons Dr
Saint James, MN 56081
Phone (507) 375-3261
501 State St N
Waseca, MN 56093
Phone (507) 835-1210
Organizations & group practices 16
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Multi-Specialty Clinic/Center
- Fairmont, MN
- NPI 1366410862
-
- Multi-Specialty Clinic/Center
- Lake City, MN
- NPI 1164463659
-
- Critical Access Hospital
- Cannon Falls, MN
- NPI 1063435410
-
- Critical Access Hospital
- New Prague, MN
- NPI 1124035282
-
- Critical Access Hospital
- Waseca, MN
- NPI 1740256668
-
- Multi-Specialty Clinic/Center
- Saint James, MN
- NPI 1023177730
-
- Critical Access Hospital
- Saint James, MN
- NPI 1639198732
-
- Multi-Specialty Clinic/Center
- Mankato, MN
- NPI 1578545422
-
- Critical Access Hospital
- Lake City, MN
- NPI 1538113022
-
- Multi-Specialty Clinic/Center
- Albert Lea, MN
- NPI 1891701637
-
- Multi-Specialty Clinic/Center
- Owatonna, MN
- NPI 1275060030
-
- Clinic Pharmacy
- Cannon Falls, MN
- NPI 1699597468
Hospital & facility affiliations 4
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Red Wing, MN
- NPI 1164400024
-
- Critical Access Hospital
- Lake City, MN
- NPI 1538113022
-
- Critical Access Hospital
- Cannon Falls, MN
- NPI 1063435410
-
- Critical Access Hospital
- Waseca, MN
- NPI 1740256668
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1278460800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1602201600000",
"number": "1003128059",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "701 HEWITT BLVD",
"city": "RED WING",
"state": "MN",
"postal_code": "550662848",
"telephone_number": "651-267-5000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "701 HEWITT BLVD",
"city": "RED WING",
"state": "MN",
"postal_code": "55066",
"telephone_number": "651-267-5000"
}
],
"practiceLocations": [
{
"address_1": "1836 South Ave",
"address_purpose": "LOCATION",
"city": "LA Crosse",
"state": "WI",
"postal_code": "546015429",
"country_code": "US",
"telephone_number": "608-782-7300",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1836 South Ave",
"address_purpose": "LOCATION",
"city": "LA Crosse",
"state": "WI",
"postal_code": "546015429",
"country_code": "US",
"telephone_number": "608-782-7300",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "LARSEN",
"first_name": "DOUGLAS",
"middle_name": "STEVEN",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2010-07-07",
"last_updated": "2020-10-09",
"certification_date": "2020-10-09",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": null,
"license": null,
"primary": false
},
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "WI",
"license": "3095",
"primary": false
},
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "MN",
"license": "12317",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "dlarsen88427@ehrdirect.mayoclinicmsg.org",
"affiliation": "N",
"address_1": "701 Hewitt Blvd",
"city": "Red Wing",
"state": "MN",
"country_code": "US",
"postal_code": "55066",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Red Wing, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.