Individual provider Active NPI

Meghan Alyssa Larose, PA-C

  • Physician Assistant
  • Auburn Hills, MI
National Provider Identifier
1205282951
Registry record updated Aug 31, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA9109489 Issued in FL
Practice address
3095 E Walton Blvd
Auburn Hills, MI 48326-2370
Phone
(248) 373-1790
NPI assigned
May 12, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 31, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA9109489 FL Primary

Addresses

Primary practice location

3095 E Walton Blvd
Auburn Hills, MI 48326-2370

Mailing address

3095 E Walton Blvd
Auburn Hills, MI 48326-2370
Phone (248) 373-1790

Other identifiers 1

IdentifierTypeStateIssuer
6W1ULOtherFLBC/BS FLORIDA BLUE

Other names 1

  • Meghan Alyssa Edwards Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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

Enrollment IDStateProvider typePAC IDDetails
I20160623001056 FL Practitioner - Physician Assistant 1456642313 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA9109489FLMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Medical Clinic, LLC CurrentSince May 31, 2016 Accepting new patients
Ohi West Medical Group II LLC CurrentSince Apr 1, 2024 Accepting new patients
Ohi West Medical Group II LLC CurrentSince Apr 1, 2024 Accepting new patients
Florida Medical Clinic LLC CurrentSince May 31, 2016 Accepting new patients

Locations

10004 N Dale Mabry Hwy
Ste 101
Tampa, FL 33618
Phone (813) 391-3990

38135 Market Square Dr
Zephyrhills, FL 33542
Phone (352) 567-0188

38135 Market Square Dr
Ste 101
Zephyrhills, FL 33542
Phone (813) 788-7651

Interoperability endpoints

  • Direct secure messaging: meghan.larose.1@31078.direct.athenahealth.com

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.

NPI Registry JSON

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

{
    "created_epoch": "1463011200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788134400000",
    "number": "1205282951",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3095 E WALTON BLVD",
            "city": "AUBURN HILLS",
            "state": "MI",
            "postal_code": "483262370",
            "telephone_number": "248-373-1790"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3095 E WALTON BLVD",
            "city": "AUBURN HILLS",
            "state": "MI",
            "postal_code": "483262370",
            "telephone_number": "248-373-1790"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAROSE",
        "first_name": "MEGHAN",
        "middle_name": "ALYSSA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-05-12",
        "last_updated": "2026-08-31",
        "certification_date": "2026-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9109489",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS FLORIDA BLUE",
            "identifier": "6W1UL",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MEGHAN",
            "last_name": "EDWARDS",
            "middle_name": "ALYSSA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Auburn Hills, MI

Sources for this page

Verify at the official NPI Registry.