Individual provider Active NPI

Joseph Allan Larsen, D.P.M

  • Foot & Ankle Surgery Podiatrist
  • Garden City Park, NY
National Provider Identifier
1629193941
Registry record updated Mar 24, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
N005321 Issued in NY
Practice address
2419 Jericho Tpke
Garden City Park, NY 11040-4710
Phone
(516) 294-9540
Fax
(516) 294-4119
NPI assigned
Mar 20, 2007
Last updated
Mar 24, 2009By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 24, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist 213ES0103X N005321 NY Primary

Addresses

Primary practice location

2419 Jericho Tpke
Garden City Park, NY 11040-4710

Mailing address

2419 Jericho Tpke
Garden City Park, NY 11040-4710
Phone (516) 294-9540

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081021000536 NY Practitioner - Podiatry 1557429594 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
New York College of Podiatric Medicine, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Optum Medical Care PCGroup PAC ID 9931013240, 1,013 clinicians

Practice addresses (Care Compare)

90 S Bedford Rd
Mount Kisco, NY 10549-3412
Phone (914) 241-1050

9525 Queens Blvd
Rego Park, NY 11374-4510
Phone (718) 975-5200

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
82.13 of 100Reported as group
Quality
72.13
Promoting interoperability
91
Improvement activities
40
Cost
75.81

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue234
Removal of skin lesions1-10
Removal of nail tissue1-10
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
N005321NYMDFoot & Ankle Surgery Podiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Optum Medical Care, P.C. CurrentSince Sep 1, 2022 Accepting new patients
Optum Urgent Care, PLLC CurrentSince Mar 1, 2020 Accepting new patients
Optum Medical Care, P.C. CurrentSince Sep 1, 2022 Accepting new patients
Mount Kisco Medical Group Past Accepting new patients

Locations

555 N Broadway
Jericho, NY 11753
Phone (516) 597-5070

110 S Bedford Rd
Mount Kisco, NY 10549
Phone (763) 910-9192

90 S Bedford Rd
Mount Kisco, NY 10549
Phone (914) 242-1050

2403 Jericho Tpke
New Hyde Park, NY 11040
Phone (516) 248-3210

2800 Marcus Ave
New Hyde Park, NY 11042
Phone (516) 622-6131

2800 Marcus Ave
Ste 102
New Hyde Park, NY 11042
Phone (516) 622-6040

2800 Marcus Ave
Ste 202
New Hyde Park, NY 11042
Phone (516) 216-1777

2800 Marcus Ave
Ste 207
New Hyde Park, NY 11042
Phone (516) 622-3387

Philadelphia, PA 19195

Interoperability endpoints

  • Direct secure messaging: jlarsen17849@direct.optum.com
  • Direct secure messaging: jol9152@direct.nyp.org

Organizations & group practices 4

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.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1174348800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1237852800000",
    "number": "1629193941",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2419 JERICHO TPKE",
            "city": "GARDEN CITY PARK",
            "state": "NY",
            "postal_code": "110404710",
            "telephone_number": "516-294-9540",
            "fax_number": "516-294-4119"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2419 JERICHO TPKE",
            "city": "GARDEN CITY PARK",
            "state": "NY",
            "postal_code": "110404710",
            "telephone_number": "516-294-9540",
            "fax_number": "516-294-4119"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LARSEN",
        "first_name": "JOSEPH",
        "middle_name": "ALLAN",
        "name_prefix": "Dr.",
        "credential": "D.P.M",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-20",
        "last_updated": "2009-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "NY",
            "license": "N005321",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Garden City Park, NY

Sources for this page

Verify at the official NPI Registry.