Andrew Larsen, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

019038 Issued in NY

Practice address

123 Everett Rd
Albany, NY 12205

Phone

(518) 701-2000

Fax

(518) 701-2020

NPI assigned

Sep 16, 2015

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

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: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Capital District Dermatology Associates PCGroup PAC ID 0840387353, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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.

• Capital District Dermatology Associates PC

  • Dermatology Physician
  • Glenmont, NY
  • NPI 1932281524
  Medicare reassignment Care Compare group
• Albany ENT & Allergy Services PC

  • Otolaryngology Physician
  • Albany, NY
  • NPI 1205838729
  Medicare reassignment

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

{
    "created_epoch": "1442361600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1570147200000",
    "number": "1669841920",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "123 EVERETT RD",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122051407",
            "telephone_number": "518-701-2000",
            "fax_number": "518-701-2020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "123 EVERETT RD",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "12205",
            "telephone_number": "518-701-2000",
            "fax_number": "518-701-2020"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2 Mountain View Ledge Dr",
            "address_purpose": "LOCATION",
            "city": "Gansvoort",
            "state": "NY",
            "postal_code": "12831",
            "country_code": "US",
            "telephone_number": "518-701-2000",
            "fax_number": "518-701-2020",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LARSEN",
        "first_name": "ANDREW",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-09-16",
        "last_updated": "2019-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "019038-1",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NY",
            "license": "019038",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Susan Lardner
• Emma Larkin, MHC
• Teresa M. Larkin, COTA
• Anna Terajewicz Larose, MD
• Sarah Larose, NPP
• Douglas Phillip Larsen, DO
• Karen Ann Larsen, NP
• David Lawrence Larussa, RPA-C
• Lasalle School
• Lasalle School

• Medical Physician Assistant in Albany, NY
• Providers in Albany, NY by specialty
• Medical Physician Assistant in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2019; 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.