Kristine M Larsen, PAC

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

085.000355 Issued in IL

Practice address

3800 Highland Ave Ste 105
Downers Grove, IL 60515-1558

Phone

(630) 574-8222

Fax

(630) 574-8225

NPI assigned

Jan 4, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Electronic endpoints 2

Medicare fee-for-service enrollment

Enrolled in IL

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

Specialty

Physician Assistant

Education

Other, 1987

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

University Head and Neck Associates SCGroup PAC ID 6103842950, 6 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: klarsen251543@direct.myadvocateaurora.org

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.

• University Head and Neck Associates, SC

  • Otolaryngology Physician
  • Downers Grove, IL
  • NPI 1598755456
  Medicare reassignment Care Compare group
• William Panje MD SC

  • Otolaryngology/Facial Plastic Surgery Physician
  • Tinley Park, IL
  • NPI 1407098544
  NPD (past)

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

{
    "created_epoch": "1136332800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638835200000",
    "number": "1477531150",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3800 HIGHLAND AVE STE 105",
            "city": "DOWNERS GROVE",
            "state": "IL",
            "postal_code": "605151558",
            "telephone_number": "630-574-8222",
            "fax_number": "630-574-8225"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3800 HIGHLAND AVE STE 105",
            "city": "DOWNERS GROVE",
            "state": "IL",
            "postal_code": "605151558",
            "telephone_number": "630-574-8222",
            "fax_number": "630-574-8225"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LARSEN",
        "first_name": "KRISTINE",
        "middle_name": "M",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-04",
        "last_updated": "2021-12-07",
        "certification_date": "2021-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "IL",
            "license": "085.000355",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "IL",
            "license": "085000355",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "IL",
            "license": "085000355",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085.000355",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "klarsen251543@direct.myadvocateaurora.org",
            "affiliation": "N",
            "address_1": "3800 Highland Ave Ste 105",
            "city": "Downers Grove",
            "state": "IL",
            "country_code": "US",
            "postal_code": "605151558",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicfhir.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "3800 Highland Ave Ste 105",
            "city": "Downers Grove",
            "state": "IL",
            "country_code": "US",
            "postal_code": "605151558",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Nancy M Lannan, RD, LDN
• Theresa Lao, D.D.S.
• Juliana Lappano, MS, RDN, LDN
• Larlin Health Care Inc
• Yvonne C Larose, RDH
• Craig Russell Larson, LCSW
• Jessica A Larson, M.ED., LMFT, LPC
• John Keith Larson, M. D.
• Matthew Larson, OD
• Thomas Edward Lassiter, DVM

• Physician Assistant in Downers Grove, IL
• Providers in Downers Grove, IL by specialty
• Physician Assistant in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2021; 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.