Individual provider Active NPI

Andrew Robert Larson, MD MPH

  • Family Medicine Physician
  • Flagstaff, AZ
National Provider Identifier
1336407774
Registry record updated Nov 17, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD2015-0683 Issued in NM
Practice address
801 E Hilltop Ave
Flagstaff, AZ 86001-4738
Phone
(734) 262-2430
NPI assigned
Apr 23, 2012
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 17, 2015

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 MD2015-0683 NM Primary

Addresses

Primary practice location

801 E Hilltop Ave
Flagstaff, AZ 86001-4738

Mailing address

801 E Hilltop Ave
Flagstaff, AZ 86001-4738
Phone (734) 262-2430

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20181024003142 MI Practitioner - Internal Medicine 8022232453 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Arizona College of Medicine, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Henry Ford Health SystemGroup PAC ID 0547178311, 2,550 clinicians

Practice addresses (Care Compare)

1265 N Milford Rd
Milford, MI 48381-1018
Phone (248) 685-3600

Hospital & facility affiliations

  • Henry Ford Health Hospital Hospital, Detroit, MI, CCN 230053
  • Henry Ford Health West Bloomfield Hospital Hospital, W Bloomfield, MI, CCN 230302

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal or shaving of skin growth1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD2015-0683NMMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Henry Ford Health System CurrentSince Oct 8, 2018 Accepting new patients
Henry Ford Health System Current Accepting new patients
Henr Y Ford Health System Family Medicine CurrentSince Oct 8, 2018 Accepting new patients

Locations

1 Ford Pl
Ste 2E
Detroit, MI 48202
Phone (313) 874-3953

2799 W Grand Blvd
Detroit, MI 48202
Phone (313) 876-2062

1265 N Milford Rd
Milford, MI 48381
Phone (248) 685-2222

Interoperability endpoints

  • Direct secure messaging: alarson548599@direct.hfhs.org

Organizations & group practices 3

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 2

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": "1335139200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1447718400000",
    "number": "1336407774",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 E HILLTOP AVE",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "860014738",
            "telephone_number": "734-262-2430"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 E HILLTOP AVE",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "860014738",
            "telephone_number": "734-262-2430"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LARSON",
        "first_name": "ANDREW",
        "middle_name": "ROBERT",
        "name_prefix": "Dr.",
        "credential": "MD MPH",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-04-23",
        "last_updated": "2015-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NM",
            "license": "MD2015-0683",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Flagstaff, AZ

Sources for this page

Verify at the official NPI Registry.