Individual provider Active NPI

Kayla Larson, PA-C

  • Physician Assistant
  • Chicago, IL
National Provider Identifier
1588183545
Registry record updated Dec 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
600 W Adams St
Chicago, IL 60661-3604
Phone
(312) 506-0900
NPI assigned
Sep 11, 2017
Last updated
Dec 10, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 10, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X IL Primary

Addresses

Primary practice location

600 W Adams St
Chicago, IL 60661-3604

Mailing address

600 W Adams St
Chicago, IL 60661-3604
Phone (312) 506-0900

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, WA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20171229000463 IL Practitioner - Physician Assistant 4688932312 Reassigns benefits to 1 organization
I20221021001210 WA Practitioner - Physician Assistant 4688932312 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Peacehealth Networks on Demand LLCGroup PAC ID 1759731383, 197 clinicians

Practice addresses (Care Compare)

10541 NE 4TH St
Bellevue, WA 98004-5023
Phone (864) 664-3984

17705 140TH Ave NE
Suite A18
Woodinville, WA 98072-4372
Phone (864) 664-3984

19220 Alderwood Mall Pkwy
Suite 145
Lynnwood, WA 98036-4819
Phone (864) 664-3984

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Carbon Health Medical Group of Florida PA CurrentSince Nov 1, 2022 Accepting new patients
Carbon Health Medical Group of Florida PA CurrentSince Nov 1, 2022 Accepting new patients
Pic Wisconsin SC PastSince Sep 25, 2019 Accepting new patients
Zoomcare PC Past Accepting new patients

Locations

11100 NE 6th St
Bellevue, WA 98004
Phone (206) 350-7345

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/30646/brand/1/csg/1/fhir/r4

Organizations & group practices 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1505088000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607558400000",
    "number": "1588183545",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 W ADAMS ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606613604",
            "telephone_number": "312-506-0900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 W ADAMS ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606613604",
            "telephone_number": "312-506-0900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LARSON",
        "first_name": "KAYLA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-09-11",
        "last_updated": "2020-12-10",
        "certification_date": "2020-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.