Individual provider Active NPI

Larissa Rolim, DPM, MS

  • Foot & Ankle Surgery Podiatrist
  • Irving, TX
National Provider Identifier
1144678517
Registry record updated Jul 9, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
2199 Issued in TX
Practice address
1440 N Macarthur Blvd Ste 101
Irving, TX 75061-4401
Phone
(469) 777-4078
Fax
(469) 777-4051
NPI assigned
May 26, 2016
Last updated
Jul 9, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist 213ES0103X 2199 TX Primary

Addresses

Primary practice location

1440 N Macarthur Blvd Ste 101
Irving, TX 75061-4401

Mailing address

1440 N Macarthur Blvd Ste 101
Irving, TX 75061-4401
Phone (469) 777-4078

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161129000087 TX Practitioner - Podiatry 3072893569 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Barry University School of Podiatric Medicine, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Maverick Foot and Ankle Specialists PLLCGroup PAC ID 0941621197, 2 clinicians

Practice addresses (Care Compare)

1440 N Macarthur Blvd
Suite 101
Irving, TX 75061-4401
Phone (469) 777-4078

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue105
Removal of skin lesions13
Removal of nail tissue57
Removal or shaving of skin growth1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

Practice roles

OrganizationSpecialtyStatusNew patients
Maverick Foot and Ankle Specialists PLLC Foot & Ankle Surgery CurrentSince Apr 1, 2020 Accepting new patients
Academy Foot & Ankle Specialists, P.a. CurrentSince Oct 3, 2016 Accepting new patients
Kwong Orthopedics and Sports Medicine, PLLC PastSince Jul 1, 2020 Accepting new patients

Locations

1440 N MacArthur Blvd
Ste 101
Irving, TX 75061
Phone (469) 777-4078

1940 E State Highway 114
Ste 150
Southlake, TX 76092
Phone (817) 424-3688

Organizations & group practices 3

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 4

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": "1464220800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1594252800000",
    "number": "1144678517",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1440 N MACARTHUR BLVD STE 101",
            "city": "IRVING",
            "state": "TX",
            "postal_code": "750614401",
            "telephone_number": "469-777-4078",
            "fax_number": "469-777-4051"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1440 N MACARTHUR BLVD STE 101",
            "city": "IRVING",
            "state": "TX",
            "postal_code": "750614401",
            "telephone_number": "469-777-4078",
            "fax_number": "469-777-4051"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROLIM",
        "first_name": "LARISSA",
        "credential": "DPM, MS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-05-26",
        "last_updated": "2020-07-09",
        "certification_date": "2020-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "TX",
            "license": "2199",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Irving, TX

Sources for this page

Verify at the official NPI Registry.