Larisa Ann Gillern, PHYSICIAN ASSISTANT

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

Practice address

5 Perryridge Rd
Greenwich, CT 06830-4608

Phone

(203) 863-3000

NPI assigned

Jun 5, 2020

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CT

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

Specialty

Physician Assistant

Education

Other, 2021

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: ljuchniewich174443@direct.ynhh.org

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.

• Northeast Medical Group, Inc.

  • Internal Medicine Physician
  • Bridgeport, CT
  • NPI 1043278351
  Medicare reassignment NPD
• Mill Hill Medical Consultants Inc

  • Hospitalist Physician
  • Greenwich, CT
  • NPI 1881607232
  NPD

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

{
    "created_epoch": "1591315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760400000000",
    "number": "1639793557",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "74 OCEAN AVE",
            "city": "MILFORD",
            "state": "CT",
            "postal_code": "064605341",
            "telephone_number": "203-979-4882"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 PERRYRIDGE RD",
            "city": "GREENWICH",
            "state": "CT",
            "postal_code": "068304608",
            "telephone_number": "203-863-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GILLERN",
        "first_name": "LARISA",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "PHYSICIAN ASSISTANT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-06-05",
        "last_updated": "2025-10-14",
        "certification_date": "2025-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Aaron L Gerard, DC
• Molly Gerster
• Melissa Giblin, PA-C
• Stephen Potter Gilbert, LMFT
• Alyssa Gillego, M.D.
• Kimberly Macht Gilsenan, MA CCC-SLP
• Catherine Irene Gingras, LCSW
• Melissa Giraldez, RN
• Claudia Duque Gislason, RD
• Barbara Ann Gist, LCSW

• Surgical Physician Assistant in Greenwich, CT
• Providers in Greenwich, CT by specialty
• Surgical Physician Assistant in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2025; 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.