NPIMap

Individual provider Active NPI

Larisa Kachowski, MD

  • Family Medicine Physician
  • Pine Bluff, AR
National Provider Identifier
1023214574
Registry record updated Apr 13, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
E6102 Issued in AR
Practice address
1726 W42D Ave
Pine Bluff, AR 71603
Phone
(870) 619-4516
NPI assigned
Jun 22, 2007
Last updated
Apr 13, 2019By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 13, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X E6102 AR Primary

Addresses

Primary practice location

1726 W42D Ave
Pine Bluff, AR 71603

Mailing address

1726 W42D Ave
Pine Bluff, AR 71603
Phone (870) 619-4516

Other identifiers 1

IdentifierTypeStateIssuer
136556001MedicaidAR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
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
I20090609000162 AR Practitioner - Family PracticePractitioner - Emergency Medicine 5294885521 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1726 W 42ND Ave
Larisa Kachowski MD Family Medicine PLLC
Pine Bluff, AR 71603-7008
Phone (870) 619-4519

1801 W 40TH Ave
Suite 6a
Pine Bluff, AR 71603-6963
Phone (870) 541-9373

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal or shaving of skin growth1-10
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
E6102ARMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Jefferson Hospital Association, Inc Family Medicine CurrentSince Mar 20, 2011 Accepting new patients
Larisa Kachowski, MD Family Medicine CurrentSince Jul 10, 2019 Accepting new patients
Southeast Arkansas Emergency Physicians LLP CurrentSince Oct 10, 2015 Accepting new patients
Jefferson Hospital Association, Inc Family Medicine CurrentSince Feb 1, 2026 Accepting new patients
Jefferson Hospital Association Inc CurrentSince Mar 20, 2011 Accepting new patients
Southeast Arkansas Emergency Physicians LLP CurrentSince Oct 10, 2015 Accepting new patients

Locations

1015 Unity Rd
Crossett, AR 71635
Phone (870) 364-0590

1600 W 40th Ave
Pine Bluff, AR 71603
Phone (870) 541-7100

1609 W 40th Ave
Ste 403
Pine Bluff, AR 71603
Phone (870) 534-4188

1726 W 42nd Ave
Pine Bluff, AR 71603
Phone (870) 535-6800

1801 W 40th Ave
Ste 6A
Pine Bluff, AR 71603
Phone (870) 541-7393

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 5

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

NPI Registry JSON

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

{
    "created_epoch": "1182470400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1555113600000",
    "number": "1023214574",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1726 W42D AVE",
            "city": "PINE BLUFF",
            "state": "AR",
            "postal_code": "71603",
            "telephone_number": "870-619-4516"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1726 W42D AVE",
            "city": "PINE BLUFF",
            "state": "AR",
            "postal_code": "71603",
            "telephone_number": "870-619-4516"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KACHOWSKI",
        "first_name": "LARISA",
        "name_prefix": "Mrs.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-06-22",
        "last_updated": "2019-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AR",
            "license": "E6102",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "136556001",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pine Bluff, AR

Sources for this page

Verify at the official NPI Registry.