Jennifer Larson, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

11136 Issued in MN

Practice address

1026 7TH St W
Saint Paul, MN 55102-3828

Phone

(651) 241-1000

Fax

(651) 241-1030

NPI assigned

Dec 31, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Other identifiers 5

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Hennepin Healthcare System, Inc

  • Rehabilitation Hospital Unit
  • Minneapolis, MN
  • NPI 1033138136
  Medicare reassignment NPD
• Hennepin Healthcare System Inc

  • Specialty Pharmacy
  • Minneapolis, MN
  • NPI 1619567625
  NPD
• Infinite Health Collaborative, PA

  • Orthopaedic Surgery Physician
  • Bloomington, MN
  • NPI 1164474250
  NPD
• Infinite Health Collaborative, PA

  • Durable Medical Equipment & Medical Supplies
  • Hudson, WI
  • NPI 1568840916
  NPD
• TMH Physician Organization

  • Family Medicine Physician
  • Houston, TX
  • NPI 1831862291
  NPD (past)
• Tmhpo Orthopedics Department

  • Orthopaedic Trauma Physician
  • Houston, TX
  • NPI 1497795272
  NPD (past)

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

{
    "created_epoch": "1199059200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614902400000",
    "number": "1184809907",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1026 7TH ST W",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551023828",
            "telephone_number": "651-241-1000",
            "fax_number": "651-241-1030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1026 7TH ST W",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551023828",
            "telephone_number": "651-241-1000",
            "fax_number": "651-241-1030"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1000 W 140th St Unit 201",
            "address_purpose": "LOCATION",
            "city": "Burnsville",
            "state": "MN",
            "postal_code": "553374833",
            "country_code": "US",
            "telephone_number": "952-808-3000",
            "fax_number": "952-808-3001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LARSON",
        "first_name": "JENNIFER",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-12-31",
        "last_updated": "2021-03-05",
        "certification_date": "2021-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA05991",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "TX",
            "license": "PA05991",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "IL",
            "license": "085003026",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MN",
            "license": "11136",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "1184809907",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "206313302",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "206313301",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "8DC697",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "8Y5543",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Dione Larson, LP
• Gary Larson
• Grace Larson
• Gregg A Larson, DDS
• Hope Marianna Larson
• Julie Larson
• Karin Jean Larson, CNM
• Karla Larson, MD
• Karri Larson
• Leslie Larson, CPNP

• Physician Assistant in Saint Paul, MN
• Providers in Saint Paul, MN by specialty
• Physician Assistant in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2021; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.