Active NPI
Edwin K Larsen, OD
- Corneal and Contact Management Optometrist
- Napa, CA
National Provider Identifier
1720154339
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Corneal and Contact Management Optometrist
- License
- OPT 105050 TPA
- Practice address
- 1737 First St
Napa, CA 94559 - Phone
- (707) 226-5446
- Fax
- (707) 226-3772
- NPI assigned
- Nov 27, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Corneal and Contact Management Optometrist | 152WC0802X | OPT 105050 TPA | CA | Primary |
Addresses
Primary practice location
1737 First St
Napa, CA 94559
Mailing address
1737 First St
Napa, CA 94559
Phone (707) 226-5446
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| SD01015051 | Medicaid | CA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20040408001514 | CA | Practitioner - Optometry | 3375537756 | Practice locations: Napa, CA |
Care Compare profile
Medicare Care Compare- Specialty
- Optometry
- Education
- Pennsylvania College of Optometry, 1995
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
1737 1St St
Napa, CA 94559-2437
Phone (707) 226-5446
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OPT 105050 TPA | CA | MD | Corneal and Contact Management Optometrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1164585600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1327449600000",
"number": "1720154339",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1737 FIRST ST",
"city": "NAPA",
"state": "CA",
"postal_code": "94559",
"telephone_number": "707-226-5446",
"fax_number": "707-226-3772"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1737 FIRST ST",
"city": "NAPA",
"state": "CA",
"postal_code": "94559",
"telephone_number": "707-226-5446",
"fax_number": "707-226-3772"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LARSEN",
"first_name": "EDWIN",
"middle_name": "K",
"name_prefix": "Mr.",
"credential": "OD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-11-27",
"last_updated": "2012-01-25",
"status": "A"
},
"taxonomies": [
{
"code": "152WC0802X",
"taxonomy_group": "",
"desc": "Optometrist, Corneal and Contact Management",
"state": "CA",
"license": "OPT 105050 TPA",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "SD01015051",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Napa, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2012; 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.