Laresa G Deboer, M.D.

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

43130 Issued in MN

Practice address

500 S Maple St
Waconia, MN 55387-1752

Phone

(952) 442-2191

NPI assigned

May 25, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 5

Medicare fee-for-service enrollment

Enrolled in MN

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

Specialty

Emergency Medicine

Education

University of Minnesota Medical School, 1999

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Ridgeview Medical CenterGroup PAC ID 9234041997, 407 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Ridgeview Medical Center Hospital, Waconia, MN, CCN 240056

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• Ridgeview Medical Center

  • Certified Registered Nurse Anesthetist
  • Waconia, MN
  • NPI 1528364429

  MN

  Medicare reassignment Care Compare group NPD
• Minnesota Valley Health Center Inc

  • Critical Access Hospital
  • Le Sueur, MN
  • NPI 1730248907

  MN

  Medicare reassignment NPD
• Sibley Medical Center

  • Critical Access Hospital
  • Arlington, MN
  • NPI 1740240225

  MN

  Medicare reassignment NPD
• Ridgeview Medical Center

  • Diagnostic Radiology Physician
  • Waconia, MN
  • NPI 1811174923
  Care Compare group NPD
• Ridgeview Medical Center

  • Community Based Hospice Care Agency
  • Waconia, MN
  • NPI 1013045350
  Care Compare group
• Ridgeview Medical Center

  • Home Health Agency
  • Waconia, MN
  • NPI 1104954445
  Care Compare group
• Ridgeview Medical Center

  • General Acute Care Hospital
  • Waconia, MN
  • NPI 1275608457
  Care Compare group
• Ridgeview Medical Center

  • Durable Medical Equipment & Medical Supplies
  • Waconia, MN
  • NPI 1821096348
  Care Compare group
• Minnesota Valley Health Center Inc

  • Medicare Defined Swing Bed Hospital Unit
  • Le Sueur, MN
  • NPI 1215097902
  NPD
• Emergency Physicians & Consultants, PA

  • Emergency Medicine Physician
  • Waconia, MN
  • NPI 1194760009

  Emergency Medicine

  NPD (past)

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

• Ridgeview Medical Center

  • General Acute Care Hospital
  • Waconia, MN
  • NPI 1275608457

  Hospital

  Care Compare affiliation
• Ridgeview Medical Center

  • General Acute Care Hospital
  • Chaska, MN
  • NPI 1710748538

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1148515200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1196640000000",
    "number": "1316993231",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 81",
            "city": "CHASKA",
            "state": "MN",
            "postal_code": "553180081",
            "telephone_number": "888-398-3327"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 S MAPLE ST",
            "city": "WACONIA",
            "state": "MN",
            "postal_code": "553871752",
            "telephone_number": "952-442-2191"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEBOER",
        "first_name": "LARESA",
        "middle_name": "G",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-25",
        "last_updated": "2007-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MN",
            "license": "43130",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICA EMERG",
            "identifier": "39-01795",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH PARTNERS",
            "identifier": "HP32799",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERRED ONE",
            "identifier": "1027863",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "054M5DE",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UCARE",
            "identifier": "140370",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• David B. Daubert
• Holly Faye Davis, L.AC.
• Richard A Davis, MD
• Tracy M Davis, LMFT
• Dayrides, Inc
• Rebecca Theresa Dekkers, LMFT
• Samuel R Deweese, M.D.
• Daniel P Dewey, MD
• Makayla Marie Dickovich, PA-C
• Erin Marie Dolan, PA-C

• All providers in Waconia, MN
• Emergency Medicine Physician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2007; 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.