Larissa Lynn Fisher, PA

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

5601011609 Issued in MI

Practice address

1105 Sixth St
Traverse City, MI 49684-2345

Phone

(231) 935-5000

NPI assigned

Mar 9, 2023

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

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, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Grand Traverse Physician Services PCGroup PAC ID 2466963806, 119 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Munson Medical Center Hospital, Traverse City, MI, CCN 230097

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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.

• Grand Traverse Physician Services PC

  • Hospitalist Physician
  • Traverse City, MI
  • NPI 1932913217
  Medicare reassignment Care Compare group
• Sound Inpatient Physicians-Michigan, PLLC

  • Internal Medicine Physician
  • Kalamazoo, MI
  • NPI 1093967861
  Medicare reassignment
• Wexford Physician Services PC

  • Hospitalist Physician
  • Cadillac, MI
  • NPI 1649084260
  Medicare reassignment
• Sound Inpatient Physicians-Michigan PLLC

  • Internal Medicine Physician
  • Grayling, MI
  • NPI 1639311996
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Munson Medical Center

  • General Acute Care Hospital
  • Traverse City, MI
  • NPI 1952307852
  Care Compare affiliation

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

{
    "created_epoch": "1678320000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678752000000",
    "number": "1205536901",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4916 S BOONE AIRE DR",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496849507",
            "telephone_number": "231-350-8013"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1105 SIXTH ST",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496842345",
            "telephone_number": "231-935-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FISHER",
        "first_name": "LARISSA",
        "middle_name": "LYNN",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-03-09",
        "last_updated": "2023-03-14",
        "certification_date": "2023-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "5601011609",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tara L Fishback, PA-C
• Jacob William Fishbaugh, PA-C
• Karla A Fishburn, RN
• Brian R Fisher, DDS
• Daniel Robert Fisher, DDS
• Chase Anthony Fitch
• Fitness Center Physical Therapy
• Marylin Fitzgerald, M.A. LLP
• Alexandra Fitzgibbon, LMSW
• Chelsea Renell Fitzpatrick, RD

• Internal Medicine Physician in Traverse City, MI
• Providers in Traverse City, MI by specialty
• Internal Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2023; 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.