Matthew Larson, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

046010940 Issued in IL

Practice address

3450 Lacey Rd
Downers Grove, IL 60515-5430

Phone

(630) 743-4807

NPI assigned

Jun 23, 2014

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CO

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

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.

• Alex Zemke, OD, PLLC

  dba Insight Eyecare Center

  • Optometrist
  • Lakewood, CO
  • NPI 1043754419
  Medicare reassignment NPD
• Sowash Optometry Group PC

  dba VisionWorks

  • Optometrist
  • Lakewood, CO
  • NPI 1336172055
  Medicare reassignment NPD
• Sowash Optometry Group, PC

  dba Visionworks

  • Eyewear Supplier
  • Denver, CO
  • NPI 1891404174

  Optometrist

  NPD
• Midwestern University

  dba MWU Multispecialty Clinic Downers Grove

  • Clinic/Center
  • Downers Grove, IL
  • NPI 1538445317
  NPD (past)

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

{
    "created_epoch": "1403481600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1479340800000",
    "number": "1316352834",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3450 LACEY RD",
            "city": "DOWNERS GROVE",
            "state": "IL",
            "postal_code": "605155430",
            "telephone_number": "630-743-4807"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3450 LACEY RD",
            "city": "DOWNERS GROVE",
            "state": "IL",
            "postal_code": "605155430",
            "telephone_number": "630-743-4807"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LARSON",
        "first_name": "MATTHEW",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-06-23",
        "last_updated": "2016-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046010940",
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IN",
            "license": "18003852A",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "046010940",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Yvonne C Larose, RDH
• Kristine M Larsen, PAC
• Craig Russell Larson, LCSW
• Jessica A Larson, M.ED., LMFT, LPC
• John Keith Larson, M. D.
• Thomas Edward Lassiter, DVM
• Richard D. Latane, MSPT
• Jenny Ga-Yee Lau, O.D.
• Allie Marie Lauer
• Brendan William Lawler, BCBA

• Optometrist in Downers Grove, IL
• Providers in Downers Grove, IL by specialty
• Optometrist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2016; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.