Larry Nilsson, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

9754 Issued in MN

Practice address

4010 West 65TH Street
Twin Cities Orthopedics
Edina, MN 55435-4800

Phone

(952) 944-2519

Fax

(952) 944-0460

NPI assigned

Jan 5, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

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.

• Infinite Health Collaborative, PA

  • Orthopaedic Surgery Physician
  • Bloomington, MN
  • NPI 1164474250
  NPD (past)
• Infinite Health Collaborative, PA

  • Durable Medical Equipment & Medical Supplies
  • River Falls, WI
  • NPI 1144608589
  NPD (past)

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

{
    "created_epoch": "1136419200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1434412800000",
    "number": "1033197595",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4200 DAHLBERG DR",
            "address_2": "SUITE 300",
            "city": "GOLDEN VALLEY",
            "state": "MN",
            "postal_code": "554224840",
            "telephone_number": "952-456-7000",
            "fax_number": "952-944-0460"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4010 WEST 65TH STREET",
            "address_2": "TWIN CITIES ORTHOPEDICS",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554354800",
            "telephone_number": "952-944-2519",
            "fax_number": "952-944-0460"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NILSSON",
        "first_name": "LARRY",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-05",
        "last_updated": "2015-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MN",
            "license": "9754",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Vicki Lynn Niedzwieski, MS, RN
• Alyssa Nielsen
• Warren W Nielsen, MD
• Dana Niklaus
• Pamela Ann Niles, GNP
• Sullivan Sarwee Nimley
• Doina Simona Nistor, MD
• Noble Home Care Services
• Joseph E Noble, MFT
• J Robert Noel III, OPAC

• Physician Assistant in Edina, MN
• Providers in Edina, MN by specialty
• Physician Assistant in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.