NPIMap

Individual provider Active NPI

Lisa Dang Larose, M.D.

  • Diagnostic Radiology Physician
  • JB Andrews, MD
National Provider Identifier
1285933838
Registry record updated Aug 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
0101254304 Issued in VA
Practice address
1060 W Perimeter Rd
JB Andrews, MD 20762-6602
Phone
(240) 612-2020
Fax
(240) 612-3880
NPI assigned
Mar 22, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 4, 2023

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Preventive Medicine/Occupational Environmental Medicine Physician 2083P0500X 0101254304 VA
General Practice Physician 208D00000X 0101254304 VA
Student in an Organized Health Care Education/Training Program 390200000X
Diagnostic Radiology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2085R0202X 0101254304 VA Primary

Addresses

Primary practice location

1060 W Perimeter Rd
JB Andrews, MD 20762-6602

Mailing address

Malcolm Grow Medical Clinics and Surgery Center
1060 W. Perimeter Rd
JB Andrews, MD 20762
Phone (240) 612-2020

Other practice location 1

3404 Tennessee Dr
Alexandria, VA 22303-1225
Phone (301) 980-4337

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210924002362 DC Practitioner - Diagnostic Radiology 5193047025 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
81.49 of 100Reported as group
Quality
60.52
Promoting interoperability
100
Improvement activities
40
Cost
68.7

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Carilion Giles Community Hospital CurrentSince Sep 29, 2024 Accepting new patients
Enloe Medical Center CurrentSince Oct 1, 2021 Accepting new patients
Carilion Medical Center CurrentSince Sep 29, 2024 Accepting new patients
Carilion Tazewell Community Hospital Single Specialty CurrentSince Sep 29, 2024 Accepting new patients
Enloe Medical Center Single Specialty CurrentSince Oct 1, 2021 Accepting new patients
Carilion Rockbridge Community Hospital Single Specialty CurrentSince Sep 29, 2024 Accepting new patients
Carilion Medical Center Single Specialty CurrentSince Sep 29, 2024 Accepting new patients
Carilion Giles Community Hospital Single Specialty CurrentSince Sep 29, 2024 Accepting new patients
Carilion Rockbridge Community Hospital Single Specialty Past Accepting new patients
St Luke'S Clinic LLC Single Specialty Past Accepting new patients
Enloe Medical Center Single Specialty Past Accepting new patients

Locations

1600 Esplanade
Ste C
Chico, CA 95926
Phone (530) 332-4470

22100 Bothell Everett Hwy
Bldg C
Bothell, WA 98021

Organizations & group practices 11

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": "1300752000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691107200000",
    "number": "1285933838",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "MALCOLM GROW MEDICAL CLINICS AND SURGERY CENTER",
            "address_2": "1060 W. PERIMETER RD",
            "city": "JB ANDREWS",
            "state": "MD",
            "postal_code": "20762",
            "telephone_number": "240-612-2020",
            "fax_number": "240-612-3880"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1060 W PERIMETER RD",
            "city": "JB ANDREWS",
            "state": "MD",
            "postal_code": "207626602",
            "telephone_number": "240-612-2020",
            "fax_number": "240-612-3880"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3404 Tennessee Dr",
            "address_purpose": "LOCATION",
            "city": "Alexandria",
            "state": "VA",
            "postal_code": "223031225",
            "country_code": "US",
            "telephone_number": "301-980-4337",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LAROSE",
        "first_name": "LISA",
        "middle_name": "DANG",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-03-22",
        "last_updated": "2023-08-04",
        "certification_date": "2023-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2083P0500X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Preventive Medicine/Occupational Environmental Medicine",
            "state": "VA",
            "license": "0101254304",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "VA",
            "license": "0101254304",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "VA",
            "license": "0101254304",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in JB Andrews, MD

Sources for this page

Verify at the official NPI Registry.