Individual provider Active NPI

Lance A Larsen, MD,FACC

  • Cardiovascular Disease Physician
  • Beverly, MA
National Provider Identifier
1144240789
Registry record updated Jan 28, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
59741 Issued in MA
Practice address
75 Herrick St
Suite 206
Beverly, MA 01915-5900
Phone
(978) 927-8400
Fax
(978) 922-1452
NPI assigned
Jul 19, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 28, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 59741 MA
Cardiovascular Disease Physician 207RC0000X 59741 MA Primary

Addresses

Primary practice location

75 Herrick St
Suite 206
Beverly, MA 01915-5900

Mailing address

75 Herrick St
Suite 206
Beverly, MA 01915-5900
Phone (978) 927-8400

Other identifiers 11

IdentifierTypeStateIssuer
060058690OtherMARAILROAD MEDICARE
4231092OtherMAAETNA
2500717OtherMAUNITED HEALTHCARE
J07711OtherMABLUE CROSS BLUE SHIELD
3053024MedicaidMA
042804155OtherMACIGNA
60917OtherMAHARVARD PILGRIM
97126301OtherMANETWORK HEALTH PLAN
0016080OtherMANEIGHBORHOOD HEALTH PLAN
059741OtherMATUFTS HEALTH PLAN
32041OtherMAFALLON COMMUNITY HEALTH

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050601000953 MA Practitioner - Cardiovascular Disease (Cardiology) 7810939790 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
Tulane University School of Medicine, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Select Outpatient Services IncGroup PAC ID 4082868815, 750 clinicians
Select Rehabilitation, LLCGroup PAC ID 9032020490, 1,935 clinicians
Lahey Clinic IncGroup PAC ID 2264336528, shared by 3 NPIs, 1,381 clinicians

Practice addresses (Care Compare)

2600 Compass Rd
Glenview, IL 60026-8001

41 Mall Rd
Burlington, MA 01805-0001
Phone (781) 744-8085

Hospital & facility affiliations

  • Northeast Hospital Corporation Hospital, Beverly, MA, CCN 220033
  • Lahey Hospital & Medical Center, Burlington Hospital, Burlington, MA, CCN 220171
  • North Shore Medical Center - Hospital, Salem, MA, CCN 220035
  • Massachusetts General Hospital Hospital, Boston, MA, CCN 220071
  • Anna Jaques Hospital Hospital, Newburyport, MA, CCN 220029

Merit-based Incentive Payment System (MIPS)

Final score
91.98 of 100Reported as apm
Quality
76.59
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
59741MAMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Lahey Clinic, Inc. CurrentSince Feb 1, 2014 Accepting new patients
Lahey Clinic, Inc CurrentSince Feb 1, 2014 Accepting new patients
Beth Israel Lahey Health Specialty Care, Inc. CurrentSince Aug 1, 2015 Accepting new patients

Locations

77 Herrick St
Beverly, MA 01915
Phone (978) 927-3040

77 Herrick St
Ste 101
Beverly, MA 01915
Phone (978) 232-7115

75 Herrick St
Ste 206
Beverly, MA 01915
Phone (978) 927-8400

100 Cummings Ctr
Ste 408J
Beverly, MA 01915
Phone (978) 524-9950

41 Mall Rd
Burlington, MA 01805
Phone (781) 744-8400

298 Washington St
Gloucester, MA 01930
Phone (978) 283-4000

Interoperability endpoints

  • Direct secure messaging: llarsen23224@direct.bilh.masshiway.net

Organizations & group practices 4

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 6

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": "1153267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1390867200000",
    "number": "1144240789",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "75 HERRICK ST",
            "address_2": "SUITE 206",
            "city": "BEVERLY",
            "state": "MA",
            "postal_code": "019155900",
            "telephone_number": "978-927-8400",
            "fax_number": "978-922-1452"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75 HERRICK ST",
            "address_2": "SUITE 206",
            "city": "BEVERLY",
            "state": "MA",
            "postal_code": "019155900",
            "telephone_number": "978-927-8400",
            "fax_number": "978-922-1452"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LARSEN",
        "first_name": "LANCE",
        "middle_name": "A",
        "credential": "MD,FACC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-19",
        "last_updated": "2014-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "MA",
            "license": "59741",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "MA",
            "license": "59741",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "060058690",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "4231092",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "2500717",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "J07711",
            "state": "MA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3053024",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "042804155",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HARVARD PILGRIM",
            "identifier": "60917",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NETWORK HEALTH PLAN",
            "identifier": "97126301",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NEIGHBORHOOD HEALTH PLAN",
            "identifier": "0016080",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TUFTS HEALTH PLAN",
            "identifier": "059741",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FALLON COMMUNITY HEALTH",
            "identifier": "32041",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Beverly, MA

Sources for this page

Verify at the official NPI Registry.