NPIMap

Individual provider Active NPI

Eugene Douglas Larsen Jr., DO

  • Internal Medicine Physician
  • Price, UT
National Provider Identifier
1447513221
Registry record updated Aug 22, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
9336977-1204 Issued in UT
Practice address
280 N Hospital Dr Ste 4
Price, UT 84501
Phone
(435) 637-5690
Fax
(435) 637-9809
NPI assigned
Jun 18, 2012
Last updated
Aug 22, 2018By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 22, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 9336977-1204 UT Primary

Addresses

Primary practice location

280 N Hospital Dr Ste 4
Price, UT 84501

Mailing address

415 N 1095 W
Price, UT 84501-4243
Phone (435) 637-5690

Other identifiers 1

IdentifierTypeStateIssuer
1447513221MedicaidUT

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150903001782 UT Practitioner - Internal Medicine 8527290923 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Castleview Hospital LLCGroup PAC ID 9032021043, 5 clinicians

Practice addresses (Care Compare)

280 N Hospital Dr
Price, UT 84501-4211
Phone (435) 637-5690

90 W Main St
Castledale, UT 84513-0607
Phone (435) 381-2305

945 W Hospital Dr
Price, UT 84501-4230

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
89.37 of 100Reported as individual
Quality
91.49
Promoting interoperability
100
Improvement activities
40
Cost
73.07

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10
Removal of skin lesions17
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
9336977-1204UTMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Castleview Physician Practice LLC Current Accepting new patients
Castleview Hospital, LLC CurrentSince Jan 1, 2016 Accepting new patients
Ashley Valley Physician Practice LLC CurrentSince Jul 4, 2018 Accepting new patients
Castleview Hospital, LLC Internal Medicine CurrentSince Jan 1, 2016 Accepting new patients
Castleview Physician Practices, LLC CurrentSince Oct 30, 2017 Accepting new patients
Pine Top Medical P.C. CurrentSince Jun 25, 2015 Accepting new patients
Ashley Valley Physician Practice, LLC Internal Medicine Current Accepting new patients
Ashley Valley Physician Practice, LLC CurrentSince Jul 4, 2018 Accepting new patients

Locations

330 Seven Springs Way
Brentwood, TN 37027
Phone (615) 920-7780

280 N Hospital Dr
Ste 4
Price, UT 84501
Phone (435) 637-3584

284 N Hospital Dr
Ste 2
Price, UT 84501
Phone (435) 613-1450

300 N Hospital Dr
Price, UT 84501
Phone (435) 636-4836

175 N 100 W
Ste 104
Vernal, UT 84078
Phone (435) 781-3053

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/HGCCDA
  • FHIR API: https://fhir4.healow.com/fhir/r4/HGCCDA/Endpoint/HGCCDA
  • Direct secure messaging: iht9016@yourcarecommunity.org

Organizations & group practices 8

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 10

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": "1339977600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1534896000000",
    "number": "1447513221",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "415 N 1095 W",
            "city": "PRICE",
            "state": "UT",
            "postal_code": "845014243",
            "telephone_number": "435-637-5690",
            "fax_number": "435-637-9809"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "280 N HOSPITAL DR STE 4",
            "city": "PRICE",
            "state": "UT",
            "postal_code": "84501",
            "telephone_number": "435-637-5690",
            "fax_number": "435-637-9809"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LARSEN",
        "first_name": "EUGENE",
        "middle_name": "DOUGLAS",
        "name_suffix": "Jr.",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-06-18",
        "last_updated": "2018-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "UT",
            "license": "9336977-1204",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1447513221",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Price, UT

Sources for this page

Verify at the official NPI Registry.