Katherine McCourt Robinson Larson, PA C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

9624 Issued in MN

Practice address

4725 36TH Ave N
Crystal, MN 55422-2169

Phone

(218) 208-2058

NPI assigned

Sep 7, 2005

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in MN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2000

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Pinnacle Dermatology SCGroup PAC ID 8628353380, 145 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

89.8 of 100Reported as group

Promoting interoperability

88

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Interoperability endpoints

• Direct secure messaging: kathy.larson@qdp.emadirect.md

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.

• Pinnacle Dermatology, SC

  • Dermatology Physician
  • Joliet, IL
  • NPI 1861930984

  MN

  Medicare reassignment Care Compare group
• Pinnacle Dermatology, SC

  • Dermatology Physician
  • Plymouth, MN
  • NPI 1609009380
  Medicare reassignment

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

{
    "created_epoch": "1126051200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643068800000",
    "number": "1154315133",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "820 SPRINGER DR",
            "city": "LOMBARD",
            "state": "IL",
            "postal_code": "601486413",
            "telephone_number": "815-744-8554"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4725 36TH AVE N",
            "city": "CRYSTAL",
            "state": "MN",
            "postal_code": "554222169",
            "telephone_number": "218-208-2058"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LARSON",
        "first_name": "KATHERINE",
        "middle_name": "MCCOURT ROBINSON",
        "name_prefix": "Mrs.",
        "credential": "PA C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-09-07",
        "last_updated": "2022-01-25",
        "certification_date": "2022-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MN",
            "license": "9624",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UCARE",
            "identifier": "131240",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "215598200",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICA",
            "identifier": "0115028",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Bethany S Kunkel, LPCC
• Mary K Laconic, OD
• Aaron Thomas Lahoud, O.D.
• Lisa Lapointe, PA-C
• Robert Larbi-Odam, MD
• Yehudis Rena Last
• Luca Oliver Lavallee
• Stephanie Albrecht Lee, PHYSICIAN ASSISTANT
• Lisa Legvold, PA-C
• William Leon, D.D.S.

• Physician Assistant in Crystal, MN
• Providers in Crystal, MN by specialty
• Physician Assistant in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.