Individual provider Active NPI

Larisa G Raastad, M.D.

  • Family Medicine Physician
  • Lacey, WA
National Provider Identifier
1316034101
Registry record updated Jun 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD00047846 Issued in WA
Practice address
1450 Northwest LN SE Ste a
Lacey, WA 98503-6908
Phone
(360) 491-4460
Fax
(360) 491-3090
NPI assigned
Oct 5, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD00047846 WA Primary

Addresses

Primary practice location

1450 Northwest LN SE Ste a
Lacey, WA 98503-6908

Mailing address

PO Box 3360
Portland, OR 97208-3360

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address lraastad671598@wm.providencedirect.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in HI
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 1

Enrollment IDStateProvider typePAC IDDetails
I20231025002692 HI Practitioner - Family Practice 3870686140 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Hawaii Permanente Medical Group IncGroup PAC ID 7618880667, 705 clinicians

Practice addresses (Care Compare)

45-602 Kamehameha Hwy
Kaneohe, HI 96744-2017
Phone (808) 432-3800

Hospital & facility affiliations

  • Kaiser Foundation Hospital Hospital, Honolulu, HI, CCN 120011

Merit-based Incentive Payment System (MIPS)

Final score
52.78 of 100Reported as group
Quality
13.33
Promoting interoperability
100
Improvement activities
0
Cost
79.27

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Hawaii Permanente Medical Group Inc CurrentSince Sep 25, 2023 Accepting new patients

Locations

711 Kapiolani Blvd
Honolulu, HI 96813
Phone (808) 432-5312

3288 Moanalua Rd
Honolulu, HI 96819
Phone (808) 265-9205

45-602 Kamehameha Hwy
Kaneohe, HI 96744
Phone (808) 432-3800

Organizations & group practices 1

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1160006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624406400000",
    "number": "1316034101",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3360",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972083360"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1450 NORTHWEST LN SE STE A",
            "city": "LACEY",
            "state": "WA",
            "postal_code": "985036908",
            "telephone_number": "360-491-4460",
            "fax_number": "360-491-3090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAASTAD",
        "first_name": "LARISA",
        "middle_name": "G",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-05",
        "last_updated": "2021-06-23",
        "certification_date": "2021-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "MD00047846",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "lraastad671598@wm.providencedirect.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1450 Northwest Ln SE Ste A",
            "city": "Lacey",
            "state": "WA",
            "country_code": "US",
            "postal_code": "985036908",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Lacey, WA

Sources for this page

Verify at the official NPI Registry.