Kristian J Larsen, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

C01347 Issued in MD

Practice address

2855 Crain Hwy
Waldorf, MD 20601-2840

Phone

(240) 427-1926

NPI assigned

Apr 12, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in DC, MD2 enrollments

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 2

Specialty

Physician Assistant

Education

Other, 1988

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Patient First Maryland Medical Group PLLCGroup PAC ID 4385538735, 258 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mdexchange@patientfirstclinics.com

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.

• CRH MD Management LLC

  • Urgent Care Clinic/Center
  • Reisterstown, MD
  • NPI 1598435059

  DC, MD

  Medicare reassignment NPD
• Patient First Maryland Medical Group PLLC

  • Family Medicine Physician
  • Silver Spring, MD
  • NPI 1265866503

  DC

  Medicare reassignment NPD
• Emergency Medicine Associates P.a., P.C.

  • Emergency Medicine Physician
  • Falls Church, VA
  • NPI 1134117393

  DC, MD

  Medicare reassignment NPD
• Patient First Maryland Medical Group, PLLC

  • Family Medicine Physician
  • Glen Allen, VA
  • NPI 1962423632

  MD

  Medicare reassignment
• CRH MD Management LLC

  • Urgent Care Clinic/Center
  • Clinton, MD
  • NPI 1972263143
  NPD
• Emergency Medicine Associates PA PC

  • Emergency Medicine Physician
  • Chestertown, MD
  • NPI 1255213070
  NPD
• Patient First Maryland Medical Group PLLC

  • Family Medicine Physician
  • Waldorf, MD
  • NPI 1205087517
  NPD
• Patient First Maryland Medical Group PLLC

  • Family Medicine Physician
  • Capitol Heights, MD
  • NPI 1427807999
  NPD
• Statcare Group, LLC

  • Urgent Care Clinic/Center
  • Prince Frederick, MD
  • NPI 1780156455
  NPD
• Emergency Medicine Associates P.a., P.C.

  • Internal Medicine Physician
  • Culpeper, VA
  • NPI 1881559102
  NPD
• Contee Emergency Physicians

  • Emergency Medicine Physician
  • Laurel, MD
  • NPI 1710936398

  Physician Assistant

  NPD (past)
• National Emergency Services District of Columbia Inc

  • Emergency Medicine Physician
  • Washington, DC
  • NPI 1588655963
  NPD (past)

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

{
    "created_epoch": "1176336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696291200000",
    "number": "1265656144",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16301 BADEN NAYLOR RD",
            "city": "BRANDYWINE",
            "state": "MD",
            "postal_code": "206138510",
            "telephone_number": "301-579-6078"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2855 CRAIN HWY",
            "city": "WALDORF",
            "state": "MD",
            "postal_code": "206012840",
            "telephone_number": "240-427-1926"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11711 Livingston Rd",
            "address_purpose": "LOCATION",
            "city": "Ft Washington",
            "state": "MD",
            "postal_code": "20744",
            "country_code": "US",
            "telephone_number": "540-389-3620",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LARSEN",
        "first_name": "KRISTIAN",
        "middle_name": "J",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-12",
        "last_updated": "2023-10-03",
        "certification_date": "2023-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MD",
            "license": "C01347",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "MDExchange@patientfirstclinics.com",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "2855 Crain Hwy",
            "city": "Waldorf",
            "state": "MD",
            "country_code": "US",
            "postal_code": "206012840",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Robert Lane Jr., DMD
• Lantern Family Services Inc
• Lantern Therapeutic Services
• Lantern Therapeutic Services, Inc
• Adam R Laplant
• Michael Harry Lasher, DDS
• Heike Lasoski
• Trevon Jerome Latson
• Tina Cornish Laury, LCPC
• Mark S Lavetti, DDS

• All providers in Waldorf, MD
• Physician Assistant in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 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.