NPIMap

Individual provider Active NPI

Marc Devries Larsen, MD

  • Emergency Medical Services (Emergency Medicine) Physician
  • Kansas City, MO
National Provider Identifier
1144236159
Registry record updated Mar 3, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medical Services (Emergency Medicine) PhysicianTaxonomy code 207PE0004X
License
2006010971 Issued in MO
Practice address
4401 Wornall Rd
Kansas City, MO 64111
Phone
(816) 932-2047
NPI assigned
Jul 31, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 3, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medical Services (Emergency Medicine) Physician 207PE0004X 2006010971 MO Primary

Addresses

Primary practice location

4401 Wornall Rd
Kansas City, MO 64111

Mailing address

PO Box 78009
St Louis, MO 63178
Phone (616) 975-9824

Other identifiers 2

IdentifierTypeStateIssuer
37548019OtherBCBS
P00393448OtherRAILROAD MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS
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
I20190925003214 KS Practitioner - Emergency Medicine 5991705816 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
University of Kansas School of Med (KC/Wich/Sal), 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mep Kansas LLCGroup PAC ID 1052437217, 61 clinicians

Practice addresses (Care Compare)

12300 Metcalf Ave
Overland Park, KS 66213-1324
Phone (913) 317-7000

Hospital & facility affiliations

  • Saint Luke'S South Hospital Hospital, Overland Park, KS, CCN 170185
  • St Lukes Hospital of Kansas City Hospital, Kansas City, MO, CCN 260138
  • Saint Luke'S East Hospital Hospital, Lees Summit, MO, CCN 260216

Merit-based Incentive Payment System (MIPS)

Final score
92.67 of 100Reported as group
Quality
93.94
Improvement activities
40
Cost
86.7

Merit-based Incentive Payment System (MIPS)

Final score
91.52 of 100Reported as group
Quality
90.41
Improvement activities
40
Cost
79.08

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2006010971MOMDEmergency Medical Services (Emergency Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
VA Eastern Kansas Health Care System CurrentSince Jul 1, 2006 Accepting new patients
Mep Kansas LLC CurrentSince Jan 1, 2021 Accepting new patients

Locations

13200 State Line Rd
Shawnee Mission, KS 66209
Phone (913) 222-8380

12300 Metcalf Ave
Shawnee Mission, KS 66213
Phone (913) 317-7000

4401 Wornall Rd
Kansas City, MO 64111
Phone (816) 932-2107

601 S US Highway 169
Smithville, MO 64089
Phone (816) 532-3999

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
St Lukes Hospital of Kansas CityKansas City, MO, CCN 260138 Hospital Corporate Director Jan 1, 2020

Owned or controlled facilities with NPI records 3

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 2

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 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": "1154304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1204502400000",
    "number": "1144236159",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 78009",
            "city": "ST LOUIS",
            "state": "MO",
            "postal_code": "63178",
            "telephone_number": "616-975-9824",
            "fax_number": "616-975-9827"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4401 WORNALL RD",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "64111",
            "telephone_number": "816-932-2047"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LARSEN",
        "first_name": "MARC",
        "middle_name": "DEVRIES",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-31",
        "last_updated": "2008-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207PE0004X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Emergency Medical Services",
            "state": "MO",
            "license": "2006010971",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "37548019",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00393448",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kansas City, MO

Sources for this page

Verify at the official NPI Registry.