Individual provider Active NPI

Cristoforo Larzo, M.D.

  • Retina Specialist (Ophthalmology) Physician
  • Kingsport, TN
National Provider Identifier
1205803285
Registry record updated Nov 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Retina Specialist (Ophthalmology) PhysicianTaxonomy code 207WX0107X
License
47455 Issued in TN
Practice address
2412 N John B Dennis Hwy
Kingsport, TN 37660-4772
Phone
(423) 578-4364
Fax
(423) 578-4372
NPI assigned
Mar 8, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Retina Specialist (Ophthalmology) Physician 207WX0107X 47455 TN Primary

Addresses

Primary practice location

2412 N John B Dennis Hwy
Kingsport, TN 37660-4772

Mailing address

9050 Executive Park Dr Ste 202a
Knoxville, TN 37923-4670
Phone (423) 756-1512

Other identifiers 4

IdentifierTypeStateIssuer
3810002341MedicaidWV
NC0241AOtherNCMEDICARE
103I187084OtherTNMEDICARE
VV2099AOtherVAMEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA, TN2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20110627000464 VA Practitioner - Ophthalmology 0042256489 Reassigns benefits to 1 organization
I20110720000414 TN Practitioner - Ophthalmology 0042256489 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
West Virginia University School of Medicine, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

160 Cummings St
Abingdon, VA 24210-3202
Phone (423) 578-4364

161 Technology LN
Johnson City, TN 37604-2010
Phone (423) 578-4364

2412 N John B Dennis Hwy
Kingsport, TN 37660-4772
Phone (423) 578-4364

Merit-based Incentive Payment System (MIPS)

Final score
90.61 of 100Reported as group
Quality
86.74
Promoting interoperability
93
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery12

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Southeastern Retina Associates, P.C. Retina Specialist Current Accepting new patients

Locations

110 Med Tech Pkwy
Ste 2
Johnson City, TN 37604
Phone (423) 722-0371

161 Technology Ln
Johnson City, TN 37604

2412 N John B Dennis Hwy
Kingsport, TN 37660
Phone (423) 378-4402

2236 E Stone Dr
Kingsport, TN 37660
Phone (423) 578-4368

Dept 888171
Knoxville, TN 37995

320 Prosperity Dr
Knoxville, TN 37923

9050 Executive Park Dr
Ste 202A
Knoxville, TN 37923

160 Cummings St
Abingdon, VA 24210

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1141776000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762214400000",
    "number": "1205803285",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9050 EXECUTIVE PARK DR STE 202A",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379234670",
            "telephone_number": "423-756-1512",
            "fax_number": "865-934-3884"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2412 N JOHN B DENNIS HWY",
            "city": "KINGSPORT",
            "state": "TN",
            "postal_code": "376604772",
            "telephone_number": "423-578-4364",
            "fax_number": "423-578-4372"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LARZO",
        "first_name": "CRISTOFORO",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-08",
        "last_updated": "2025-11-04",
        "certification_date": "2025-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207WX0107X",
            "taxonomy_group": "",
            "desc": "Ophthalmology, Retina Specialist",
            "state": "TN",
            "license": "47455",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3810002341",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "NC0241A",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "103I187084",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "VV2099A",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kingsport, TN

Sources for this page

Verify at the official NPI Registry.