NPIMap

Individual provider Active NPI

Barrett Paul Larson II, M.D.

  • Pulmonary Disease Physician
  • Waconia, MN
National Provider Identifier
1114171014
Registry record updated Dec 14, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
58802 Issued in MN
Practice address
560 S Maple St Ste 400
Waconia, MN 55387-1757
Phone
(952) 442-8011
Fax
(952) 442-7852
NPI assigned
Nov 5, 2008
Last updated
Dec 14, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 14, 2018

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 58802 MN
Critical Care Medicine (Internal Medicine) Physician 207RC0200X 58802 MN
Pulmonary Disease Physician 207RP1001X 58802 MN Primary

Addresses

Primary practice location

560 S Maple St Ste 400
Waconia, MN 55387-1757

Mailing address

500 S Maple St
Waconia, MN 55387-1791
Phone (952) 442-2191

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN, SD2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20150421000651 MN Practitioner - Pulmonary DiseasePractitioner - Critical Care (Intensivists) 3274851399 Reassigns benefits to 1 organization
I20220729001561 SD Practitioner - Pulmonary Disease 3274851399 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pulmonary Disease
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Avera McKennanGroup PAC ID 0345157103, 957 clinicians

Practice addresses (Care Compare)

1301 S Cliff Ave
Suite 610
Sioux Falls, SD 57105-1032
Phone (605) 322-8860

1325 S Cliff Ave
Sioux Falls, SD 57105-1007

4500 W 69TH St
Sioux Falls, SD 57108-8148
Phone (605) 322-9777

4520 W 69TH St
Sioux Falls, SD 57108-8148
Phone (605) 977-5000

901 E Virgil Ave
Milbank, SD 57252-2124
Phone (605) 432-4538

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
58802MNMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Avera McKennan CurrentSince Jul 1, 2022 Accepting new patients
Avera McKennan Current Accepting new patients
Avera McKennan CurrentSince Jan 6, 2025 Accepting new patients
Avera McKennan CurrentSince Jul 1, 2022 Accepting new patients
Avera McKennan Current Accepting new patients

Locations

911 5th Ave SW
Pipestone, MN 56164
Phone (507) 825-5811

Interoperability endpoints

  • Direct secure messaging: barrett.larson@avera.sdhealthlink.net

Organizations & group practices 5

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 32

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

View all 32

NPI Registry JSON

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

{
    "created_epoch": "1225843200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1544745600000",
    "number": "1114171014",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 S MAPLE ST",
            "city": "WACONIA",
            "state": "MN",
            "postal_code": "553871791",
            "telephone_number": "952-442-2191",
            "fax_number": "952-442-8055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "560 S MAPLE ST STE 400",
            "city": "WACONIA",
            "state": "MN",
            "postal_code": "553871757",
            "telephone_number": "952-442-8011",
            "fax_number": "952-442-7852"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LARSON",
        "first_name": "BARRETT",
        "middle_name": "PAUL",
        "name_prefix": "Dr.",
        "name_suffix": "II",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-11-05",
        "last_updated": "2018-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MN",
            "license": "58802",
            "primary": false
        },
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "MN",
            "license": "58802",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "MN",
            "license": "58802",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waconia, MN

Sources for this page

Verify at the official NPI Registry.