NPIMap

Individual provider Active NPI

Siri Shirene Knutsen Larson, M.D.

  • Dermatology Physician
  • Rapid City, SD
National Provider Identifier
1659696672
Registry record updated Jan 14, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
9107 Issued in SD
Practice address
717 Meade St
Suite 100
Rapid City, SD 57701-5103
Phone
(605) 341-5910
NPI assigned
Apr 1, 2010
Last updated
Jan 14, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 14, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X 9107 SD Primary

Addresses

Primary practice location

717 Meade St
Suite 100
Rapid City, SD 57701-5103

Mailing address

717 Meade St
Suite 100
Rapid City, SD 57701-5103
Phone (605) 341-5910

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SD
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140604001614 SD Practitioner - Dermatology 2860616265 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
University of South Carolina School of Medicine, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

353 Fairmont Blvd
Rapid City, SD 57701-7375
Phone (605) 755-8109

4150 5TH St
Rapid City, SD 57701-6022
Phone (605) 755-4100

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
93.78 of 100Reported as apm
Quality
80.38
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision207
Removal of skin lesions1087
Removal of skin cancer609
Removal or shaving of skin growth1-10
Skin biopsy743

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Monument Health Rapid City Hospital, Inc CurrentSince Jun 25, 2017 Accepting new patients
Monument Health Rapid City Hospital Inc CurrentSince Jun 25, 2017 Accepting new patients
Monument Health Rapid City Hospital, Inc Current Accepting new patients
Monument Health Rapid City Hospital, Inc. Past Accepting new patients

Locations

353 Fairmont Blvd
Rapid City, SD 57701
Phone (605) 719-1000

4150 5th St
Rapid City, SD 57701
Phone (605) 399-4300

717 Meade St
Ste 100
Rapid City, SD 57701
Phone (605) 341-5910

Interoperability endpoints

  • Direct secure messaging: sknutsenlarson.8543@regionalhealth.sdhealthlink.net

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 12

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": "1270080000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1421193600000",
    "number": "1659696672",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "717 MEADE ST",
            "address_2": "SUITE 100",
            "city": "RAPID CITY",
            "state": "SD",
            "postal_code": "577015103",
            "telephone_number": "605-341-5910"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "717 MEADE ST",
            "address_2": "SUITE 100",
            "city": "RAPID CITY",
            "state": "SD",
            "postal_code": "577015103",
            "telephone_number": "605-341-5910"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KNUTSEN LARSON",
        "first_name": "SIRI",
        "middle_name": "SHIRENE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-04-01",
        "last_updated": "2015-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "SD",
            "license": "9107",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rapid City, SD

Sources for this page

Verify at the official NPI Registry.