NPIMap

Individual provider Active NPI

Heather Marie Larson, PA

  • Physician Assistant
  • Orchard Park, NY
National Provider Identifier
1003249269
Registry record updated Jul 6, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
016812-1 Issued in NY
Practice address
310 Sterling Dr Ste 105
Orchard Park, NY 14127-1500
Phone
(716) 677-9220
Fax
(716) 677-9226
NPI assigned
Aug 12, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 6, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 016812-1 NY Primary

Addresses

Primary practice location

310 Sterling Dr Ste 105
Orchard Park, NY 14127-1500

Mailing address

199 Park Club LN Ste 500
Williamsville, NY 14221-5269
Phone (716) 845-1300

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130916000426 NY Practitioner - Physician Assistant 3971747882 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southtowns Gastroenterology, PLLCGroup PAC ID 8123204658, 3 clinicians

Practice addresses (Care Compare)

3065 Southwestern Blvd
Orchard Park, NY 14127-1239

310 Sterling Dr
S 105
Orchard Park, NY 14127-1239

310 Sterling Dr
Suite 105
Orchard Park, NY 14127-1500
Phone 7166779220115

Hospital & facility affiliations

  • Sisters of Charity Hospital Hospital, Buffalo, NY, CCN 330078
  • Mercy Hospital of Buffalo Hospital, Buffalo, NY, CCN 330279
  • Brooks-TLC Hospital System, Inc Hospital, Dunkirk, NY, CCN 330229
  • Kaleida Health Hospital, Buffalo, NY, CCN 330005

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
016812-1NYMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Trinity Medical Wny PC Past Accepting new patients
Rpci Oncology PC PastSince Jun 15, 2025 Accepting new patients

Organizations & group practices 3

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.

Hospital & facility affiliations 13

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 13

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1376265600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783296000000",
    "number": "1003249269",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "199 PARK CLUB LN STE 500",
            "city": "WILLIAMSVILLE",
            "state": "NY",
            "postal_code": "142215269",
            "telephone_number": "716-845-1300",
            "fax_number": "716-322-3372"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "310 STERLING DR STE 105",
            "city": "ORCHARD PARK",
            "state": "NY",
            "postal_code": "141271500",
            "telephone_number": "716-677-9220",
            "fax_number": "716-677-9226"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LARSON",
        "first_name": "HEATHER",
        "middle_name": "MARIE",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-08-12",
        "last_updated": "2026-07-06",
        "certification_date": "2026-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "016812-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orchard Park, NY

Sources for this page

Verify at the official NPI Registry.