Individual provider Active NPI

Leslie Chaskes Larsen, RN, MS, CPNP

  • Pediatric Nurse Practitioner
  • Phoenix, AZ
National Provider Identifier
1508816984
Registry record updated Dec 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
AP11792 Issued in AZ
Practice address
500 W Thomas Rd Ste 250
Phoenix, AZ 85013-4215
Phone
(602) 406-3520
Fax
(602) 406-6162
NPI assigned
May 10, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 6, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X AP11792 AZ Primary

Addresses

Primary practice location

500 W Thomas Rd Ste 250
Phoenix, AZ 85013-4215

Mailing address

PO Box 33269
Phoenix, AZ 85067-3269
Phone (602) 406-4786

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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
I20190627001025 AZ Practitioner - Nurse Practitioner 7416281258 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Pediatric Nurse Practitioner, Master of Science, Nurse Practitioner, Registered Nurse

State licenses

LicenseStateTypeSpecialty
AP11792AZMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
St. Joseph'S Hospital and Medical Center CurrentSince Aug 30, 2020 Accepting new patients
Sjhmc Physician Services CurrentSince Jul 1, 2019 Accepting new patients

Locations

350 W Thomas Rd
Phoenix, AZ 85013
Phone (480) 339-5001

500 W Thomas Rd
Ste 680
Phoenix, AZ 85013
Phone (602) 406-6017

3030 N Central Ave
Ste 1001
Phoenix, AZ 85012

500 W Thomas Rd
Ste 250
Phoenix, AZ 85013
Phone (602) 263-9345

File 56765
Los Angeles, CA 90074

Organizations & group practices 2

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": "1147219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733443200000",
    "number": "1508816984",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 33269",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850673269",
            "telephone_number": "602-406-4786",
            "fax_number": "916-636-4358"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 W THOMAS RD STE 250",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850134215",
            "telephone_number": "602-406-3520",
            "fax_number": "602-406-6162"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LARSEN",
        "first_name": "LESLIE",
        "middle_name": "CHASKES",
        "name_prefix": "Mrs.",
        "credential": "RN, MS, CPNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-10",
        "last_updated": "2024-12-06",
        "certification_date": "2024-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "AZ",
            "license": "AP11792",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.