Individual provider Active NPI

Tory Leif Larsen, APRN, NP

  • Acute Care Nurse Practitioner
  • Cambridge, MA
National Provider Identifier
1669920179
Registry record updated Jun 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
2308024 Issued in MA
Practice address
872 Mass Ave
Apt 503
Cambridge, MA 02139-3073
Phone
(973) 919-4816
NPI assigned
Sep 13, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 21, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 2308024 MA Primary

Addresses

Primary practice location

872 Mass Ave
Apt 503
Cambridge, MA 02139-3073

Mailing address

872 Mass Ave
Apt 503
Cambridge, MA 02139-3073
Phone (973) 919-4816

Other practice location 1

725 Albany St, Suite 7B
Shapiro Bldg
Boston, MA 02118
Phone (617) 638-8456

Other identifiers 1

IdentifierTypeStateIssuer
110122144AMedicaidMA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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

Enrollment IDStateProvider typePAC IDDetails
I20170504000068 MA Practitioner - Nurse Practitioner 6002193893 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lahey Clinic IncGroup PAC ID 2264336528, shared by 3 NPIs, 1,381 clinicians

Practice addresses (Care Compare)

29 Mall Rd
Burlington, MA 01805-0001

41 Highland Ave
Winchester, MA 01890-1446
Phone (781) 729-9000

41 Mall Rd
Burlington, MA 01805-0001

Hospital & facility affiliations

  • Lahey Hospital & Medical Center, Burlington Hospital, Burlington, MA, CCN 220171
  • Northeast Hospital Corporation Hospital, Beverly, MA, CCN 220033
  • Winchester Hospital Hospital, Winchester, MA, CCN 220105

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
2308024MAMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Boston Medical Center Corporation Current Accepting new patients
Boston University Neurology Associates, Inc. CurrentSince Feb 1, 2023 Accepting new patients
Lahey Clinic, Inc CurrentSince May 1, 2017 Accepting new patients
Lahey Clinic, Inc. CurrentSince May 1, 2017 Accepting new patients

Locations

725 Albany St
Ste 7
Boston, MA 02118
Phone (617) 638-8456

725 Albany St
Ste 7B
Boston, MA 02118
Phone (617) 638-7490

41 Mall Rd
Burlington, MA 01805
Phone (781) 744-8400

Interoperability endpoints

  • Direct secure messaging: tlarsen86286@direct.bilh.masshiway.net
  • Direct secure messaging: tlarsen96542@direct.bmc.masshiway.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 and National Provider Directory roles.

Hospital & facility affiliations 4

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": "1473724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687305600000",
    "number": "1669920179",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "872 MASS AVE",
            "address_2": "APT 503",
            "city": "CAMBRIDGE",
            "state": "MA",
            "postal_code": "021393073",
            "telephone_number": "973-919-4816"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "872 MASS AVE",
            "address_2": "APT 503",
            "city": "CAMBRIDGE",
            "state": "MA",
            "postal_code": "021393073",
            "telephone_number": "973-919-4816"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "725 Albany St, Suite 7B",
            "address_2": "Shapiro Bldg",
            "address_purpose": "LOCATION",
            "city": "Boston",
            "state": "MA",
            "postal_code": "02118",
            "country_code": "US",
            "telephone_number": "617-638-8456",
            "fax_number": "617-638-8465",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LARSEN",
        "first_name": "TORY",
        "middle_name": "LEIF",
        "name_prefix": "Mr.",
        "credential": "APRN, NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-09-13",
        "last_updated": "2023-06-21",
        "certification_date": "2023-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "MA",
            "license": "2308024",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110122144A",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cambridge, MA

Sources for this page

Verify at the official NPI Registry.