Jessica Ann Larsen, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

002051 Issued in IA

Practice address

1500 Associates Dr
Dubuque, IA 52002-2201

Phone

(563) 584-4425

Fax

(563) 584-4427

NPI assigned

Dec 31, 2009

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Jessica Ann Gerlach Former name

Medicare fee-for-service enrollment

Enrolled in IA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Medical Associates Clinic P CGroup PAC ID 3870491228, 228 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• Medical Associates Clinic P C

  • Multi-Specialty Clinic/Center
  • Dubuque, IA
  • NPI 1457300790
  Medicare reassignment Care Compare group NPD
• Floyd County Memorial Hospital Commission

  • Critical Access Hospital
  • Charles City, IA
  • NPI 1265402390
  NPD (past)

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

{
    "created_epoch": "1262217600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1398729600000",
    "number": "1013247733",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 ASSOCIATES DR",
            "city": "DUBUQUE",
            "state": "IA",
            "postal_code": "520022201",
            "telephone_number": "563-584-4100",
            "fax_number": "563-584-4110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 ASSOCIATES DR",
            "city": "DUBUQUE",
            "state": "IA",
            "postal_code": "520022201",
            "telephone_number": "563-584-4425",
            "fax_number": "563-584-4427"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LARSEN",
        "first_name": "JESSICA",
        "middle_name": "ANN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-12-31",
        "last_updated": "2014-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IA",
            "license": "002051",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "002051",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JESSICA",
            "last_name": "GERLACH",
            "middle_name": "ANN",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Physician Assistant in Dubuque, IA
• Providers in Dubuque, IA by specialty
• Physician Assistant in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2014; 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.

Verify at the official NPI Registry.