Individual provider Active NPI

Marion Rose Larson, PA

  • Medical Physician Assistant
  • Tacoma, WA
National Provider Identifier
1437521655
Registry record updated Sep 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
Practice address
1222 S 72ND St
Tacoma, WA 98408-3009
Phone
(979) 739-5847
NPI assigned
Oct 27, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 24, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X WA Primary

Addresses

Primary practice location

1222 S 72ND St
Tacoma, WA 98408-3009

Mailing address

1222 S 72ND St
Tacoma, WA 98408-3009
Phone (979) 739-5847

Other names 1

  • Mrs. Marion Larson Lupfer Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160223001679 WA Practitioner - Physician Assistant 5799080198 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

102 Ponderosa Dr
Spearfish, SD 57783-6029

2920 Telegraph Ave
Suite 100
Berkeley, CA 94705-2031

5080 Spectrum Dr
Suite 1200W
Addison, TX 75001-6443

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Carbon Health Medical Group of Florida PA CurrentSince May 7, 2024 Accepting new patients
Providence Health & Services Washington CurrentSince Nov 18, 2016 Accepting new patients
Tran Urgent Care & Wellness Centers LLC Past Accepting new patients

Locations

525 Lilly Rd NE
Olympia, WA 98506
Phone (360) 413-8550

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/21373/brand/1/csg/1/fhir/r4

Organizations & group practices 6

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": "1445904000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727136000000",
    "number": "1437521655",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1222 S 72ND ST",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984083009",
            "telephone_number": "979-739-5847"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1222 S 72ND ST",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984083009",
            "telephone_number": "979-739-5847"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LARSON",
        "first_name": "MARION",
        "middle_name": "ROSE",
        "name_prefix": "Ms.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-10-27",
        "last_updated": "2024-09-24",
        "certification_date": "2024-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "WA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARION",
            "last_name": "LUPFER",
            "middle_name": "LARSON",
            "prefix": "MRS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Tacoma, WA

Sources for this page

Verify at the official NPI Registry.