Larry Douglas Van Fossen, D.O.

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

License

OS18532 Issued in FL

Practice address

5955 Rand Blvd
Sarasota, FL 34238-5160

Phone

(941) 893-6620

Fax

(941) 748-8440

NPI assigned

Jul 25, 2006

Last updated

Mar 28, 2023By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in FL

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

Specialty

Anesthesiology

Education

Ohio State University College of Homeopathic Medicine, 1990

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Northwood Anesthesia Associates LLCGroup PAC ID 8022920255, 40 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

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.

• Northwood Anesthesia Associates LLC

  • Anesthesiology Physician
  • Venice, FL
  • NPI 1811569197
  Medicare reassignment Care Compare group NPD
• Capital Anesthesia Solutions of Florida II, LLC

  • Anesthesiology Physician
  • Naples, FL
  • NPI 1891318481
  Medicare reassignment NPD
• Florida Cancer Specialists & Research Institute, LLC

  • Medical Oncology Physician
  • Cape Coral, FL
  • NPI 1760590962
  Medicare reassignment NPD
• Northwood Anesthesia Associates LLC

  • Anesthesiology Physician
  • Trinity, FL
  • NPI 1780256073
  NPD
• Ohiohealth Corporation

  dba OhioHealth Physician Group, Inc

  • Family Medicine Physician
  • Columbus, OH
  • NPI 1578545273

  Pain Medicine

  NPD
• Anesthesiology Services Network LTD

  • Anesthesiology Physician
  • Dayton, OH
  • NPI 1821076779
  NPD (past)
• Ashland Anesthesia, PSC. Inc.

  • Anesthesiology Physician
  • Ashland, OH
  • NPI 1669432084
  NPD (past)
• Kettering Anesthesia Associates, Inc

  • Anesthesiology Physician
  • Kettering, OH
  • NPI 1689627739
  NPD (past)
• Licking Memorial Professional Corporation

  dba Licking Memorial Anesthesiology

  • Anesthesiology Physician
  • Newark, OH
  • NPI 1376585430
  NPD (past)
• Orange ASC, LTD

  dba Orthopedic ONE Surgery Center at Easton

  • Ambulatory Surgical Clinic/Center
  • Columbus, OH
  • NPI 1619333010
  NPD (past)
• Riverside Radiology and Interventional Associates Inc

  • Diagnostic Radiology Physician
  • Columbus, OH
  • NPI 1093718496
  NPD (past)
• Rural Anesthesia Management, LLC

  • Anesthesiology Physician
  • Marysville, OH
  • NPI 1437108164
  NPD (past)

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

{
    "created_epoch": "1153785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679961600000",
    "number": "1497778054",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5955 RAND BLVD",
            "city": "SARASOTA",
            "state": "FL",
            "postal_code": "342385160",
            "telephone_number": "941-893-6620",
            "fax_number": "941-748-8440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5955 RAND BLVD",
            "city": "SARASOTA",
            "state": "FL",
            "postal_code": "342385160",
            "telephone_number": "941-893-6620",
            "fax_number": "941-748-8440"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "600 N Cattlemen Rd Ste 200",
            "address_purpose": "LOCATION",
            "city": "Sarasota",
            "state": "FL",
            "postal_code": "342326422",
            "country_code": "US",
            "telephone_number": "941-377-9993",
            "fax_number": "941-343-0026",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VAN FOSSEN",
        "first_name": "LARRY",
        "middle_name": "DOUGLAS",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-25",
        "last_updated": "2023-03-28",
        "certification_date": "2023-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "FL",
            "license": "OS18532",
            "primary": true
        },
        {
            "code": "207LH0002X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Hospice and Palliative Medicine",
            "state": "OH",
            "license": "34.005429",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0981826",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "114329900",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "300135298",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Marlene Renae Valles
• Kristine Vallrugo, M.D.
• Daylen D Valoria Campos
• Jeannette Valoy Torres
• Harriet Van Elburg, R.P.T.
• Sandra T. F Van Gennip, ARNP
• Sarah Elizabeth Van Nostrand, OTL
• Ashley S Van Olst, CRNA
• Leonie M Van Passel, MD
• Van Praag Chiropractic

• Anesthesiology Physician in Sarasota, FL
• Providers in Sarasota, FL by specialty
• Anesthesiology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2023; 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.