Andrew Jon Larson, D.O.

Primary specialty

Dermatopathology (Pathology) PhysicianTaxonomy code 207ZD0900X

License

02003283A Issued in IN

Practice address

9900 13TH Avenue North
Suite 2a
Plymouth, MN 55441-5035

Phone

(763) 525-0363

Fax

(763) 525-0369

NPI assigned

Jun 23, 2009

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MN

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

Pathology

Education

Other, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Dermatology Specialists, PAGroup PAC ID 1456248137, 18 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

79.35 of 100Reported as group

Quality

58.09

Improvement activities

40

Cost

87.03

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 and National Provider Directory roles.

• Dermatology Specialists, PA

  • Dermatology Physician
  • Edina, MN
  • NPI 1992752117
  Medicare reassignment Care Compare group NPD
• Fairview Express Care

  • Multi-Specialty Clinic/Center
  • Minneapolis, MN
  • NPI 1053952606
  Medicare reassignment NPD
• Fairview Express Care

  • Specialist
  • Saint Paul, MN
  • NPI 1679048763
  NPD
• Fairview Express Care

  • General Practice Physician
  • Edina, MN
  • NPI 1831707207
  NPD

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

{
    "created_epoch": "1245715200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1413504000000",
    "number": "1528296043",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9900 13TH AVENUE NORTH",
            "address_2": "SUITE 2A",
            "city": "PLYMOUTH",
            "state": "MN",
            "postal_code": "554415035",
            "telephone_number": "763-525-0363",
            "fax_number": "763-525-0369"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9900 13TH AVENUE NORTH",
            "address_2": "SUITE 2A",
            "city": "PLYMOUTH",
            "state": "MN",
            "postal_code": "554415035",
            "telephone_number": "763-525-0363",
            "fax_number": "763-525-0369"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LARSON",
        "first_name": "ANDREW",
        "middle_name": "JON",
        "name_prefix": "Mr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-06-23",
        "last_updated": "2014-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZD0900X",
            "taxonomy_group": "",
            "desc": "Pathology, Dermatopathology",
            "state": "IN",
            "license": "02003283A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIANA PROFESSIONAL LICENSING AGENCY",
            "identifier": "02003283A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jill Landecker, PHARM.D.
• George Harold Landis, MD
• Kristeen Joanne Laplant Young, LPCC, LADC
• Jessica Lynn Larkin, D.C.
• Kelly Jean Larsgard
• Megan Elaine Larson, RD, LD
• Richard Thomas Larson II, D.C.
• Roberta G. Larson, L.I.C.S.W.
• Tony Larson
• William L Laspe, D.D.S.

• Dermatopathology (Pathology) Physician in Plymouth, MN
• Providers in Plymouth, MN by specialty
• Dermatopathology (Pathology) Physician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2014; 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.