NPIMap

Individual provider Active NPI

Jeffrey D Larsen, MD

  • Internal Medicine Physician
  • River Falls, WI
National Provider Identifier
1104819622
Registry record updated Aug 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
37621 Issued in WI
Practice address
319 S Main St
River Falls, WI 54022-2452
Phone
(715) 425-6701
NPI assigned
Aug 30, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 37621 WI Primary

Addresses

Primary practice location

319 S Main St
River Falls, WI 54022-2452

Mailing address

1700 University Ave W # 6TH
Saint Paul, MN 55104-3727
Phone (651) 232-1123

Other identifiers 1

IdentifierTypeStateIssuer
32225000MedicaidWI

Other names 1

  • Jeff D Larsen Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
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
I20100715000089 WI Practitioner - Internal Medicine 3173424538 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Minnesota Medical School, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Allina Health SystemGroup PAC ID 4587573613, 3,844 clinicians
Fairview Express CareGroup PAC ID 3375645179, 1,946 clinicians
Fairview ClinicsGroup PAC ID 7113830142, 799 clinicians

Practice addresses (Care Compare)

1629 E Division St
River Falls, WI 54022-1571
Phone (612) 262-1200

1687 E Division St
River Falls, WI 54022-1571
Phone (715) 307-6432

2651 Hillcrest Dr
Suite 302
Hudson, WI 54016-9919
Phone (612) 365-5000

319 S Main St
River Falls, WI 54022-2452
Phone (715) 425-6701

Hospital & facility affiliations

  • Adoray Home Health and Hospice Home health agency, Baldwin, WI, CCN 527137
  • Interim Healthcare of Western Wisconsin Home health agency, Hudson, WI, CCN 527291
  • Accentcare Fairview Home Health - East LLC Home health agency, Oakdale, MN, CCN 247166
  • M Health Fairview University of MN Medical Center Hospital, Minneapolis, MN, CCN 240080
  • River Falls Area Hospital Hospital, River Falls, WI, CCN 521349
  • M Health Fairview Woodwinds Hospital Hospital, Woodbury, MN, CCN 240213
  • M Health Fairview St John'S Hospital Hospital, Maplewood, MN, CCN 240210
  • Western Wisconsin Health Hospital, Baldwin, WI, CCN 521347
  • River Falls Area Hospital Nursing home, CCN 52Z349

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Allina Health System CurrentSince Nov 1, 2015 Accepting new patients
Fairview Clinics CurrentSince Oct 10, 2020 Accepting new patients
Fairview Express Care CurrentSince Jul 1, 2022 Accepting new patients
Fairview Express Care Current Accepting new patients
Western Wisconsin Medical Associates CurrentSince Jan 1, 1997 Accepting new patients
Allina Health System Current Accepting new patients
Fairview Express Care CurrentSince Jul 1, 2022 Accepting new patients
Allina Health System CurrentSince Nov 1, 2015 Accepting new patients

Locations

1700 University Ave W
Saint Paul, MN 55104
Phone (612) 672-6740

144 S Plum St
Ellsworth, WI 54011
Phone (715) 273-5041

2651 Hillcrest Dr
Ste 302
Hudson, WI 54016
Phone (651) 241-5290

319 S Main St
River Falls, WI 54022
Phone (715) 425-6701

1687 E Division St
River Falls, WI 54022
Phone (715) 425-6701

1629 E Division St
River Falls, WI 54022
Phone (715) 307-6000

Interoperability endpoints

  • Direct secure messaging: jlarsen491043@fairview.direct-ci.com
  • Direct secure messaging: jeffrey.larsen@vibranthealth.cernerdirect.com

Organizations & group practices 9

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 14

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

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1125360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691366400000",
    "number": "1104819622",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1700 UNIVERSITY AVE W # 6TH",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551043727",
            "telephone_number": "651-232-1123"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "319 S MAIN ST",
            "city": "RIVER FALLS",
            "state": "WI",
            "postal_code": "540222452",
            "telephone_number": "715-425-6701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LARSEN",
        "first_name": "JEFFREY",
        "middle_name": "D",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-30",
        "last_updated": "2023-08-07",
        "certification_date": "2023-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WI",
            "license": "37621",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "32225000",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JEFF",
            "last_name": "LARSEN",
            "middle_name": "D",
            "credential": "MD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in River Falls, WI

Sources for this page

Verify at the official NPI Registry.