Benjamin R Larsen, PT
Individual provider Active NPI Physical Therapist · Cheyenne, WY
NPI 1487974887 · NPPES record last updated Sep 30, 2021
Key facts
- NPI
- 1487974887
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- PT-1325 (WY)
- Practice address
- 603 E Carlson St Ste 304
Cheyenne, WY 82009-4443 - Phone
- (307) 514-9999
- Fax
- (307) 514-6006
- NPI assigned
- Jun 8, 2010
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 2
Medicare Care Compare profile
- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 2010
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Top Therapy PC
Practice addresses (Care Compare)
603 E Carlson St
Suite 304
Cheyenne, WY 82009-4443
Phone (307) 514-9999
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in WY
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20100915000554 | WY | Practitioner - Physical Therapist in Private Practice | 0840315792 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT-1325 | WY | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Top Therapy, PC | Physical Therapist | Current |
Accepting new patients |
| Teton Therapy, P.C. | Physical Therapist | Current |
Accepting new patients |
Locations
603 E Carlson St
Ste 304
Cheyenne, WY 82009
Phone (307) 514-9999
425 Lincoln St
Ste 2
Lander, WY 82520
Phone (307) 332-2230
1406 W Main St
Riverton, WY 82501
Phone (307) 463-0462
820 W Main St
Riverton, WY 82501
Phone (307) 463-0462
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT-1325 | WY | Yes |
Addresses
Primary practice location
603 E Carlson St Ste 304
Cheyenne, WY 82009-4443
Mailing address
1406 W Main St
Riverton, WY 82501-3239
Phone (307) 463-0462
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 129616700 | Medicaid | WY |
Other providers in Cheyenne, WY
- Laramie County Chiropractic
- Laramie County School District 1
- Laramie Health Supplies
- David Lariccia
- Ellen Lariccia
- Trenette Ann Larson
- Becky Marie Lauridsen
- Cheryl Lavoy
- Mercedes Lavoy
- Jason P Lawandales
All providers in Cheyenne, WY · Physical Therapist in Wyoming
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 30, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.