NPIMap

Individual provider Active NPI

Amy Larsen, MD

  • Internal Medicine Physician
  • Saint Paul, MN
National Provider Identifier
1720168537
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
46577 Issued in MN
Practice address
640 Jackson St
Saint Paul, MN 55101-2502
Phone
(651) 254-3456
Fax
(651) 254-9673
NPI assigned
Oct 16, 2006
Last updated
Mar 17, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Pathology/Laboratory Medicine Physician 207ZP0105X 46577 MN
Internal Medicine Physician 207R00000X 46577 MN Primary

Addresses

Primary practice location

640 Jackson St
Saint Paul, MN 55101-2502

Mailing address

PO Box 1309
Ms 21110Q
Minneapolis, MN 55440-1309
Phone (651) 254-3456

Other practice location 1

210 9th St SE
Rochester, MN 55904-6756
Phone (507) 529-6616

Other practice location 2

210 9th St SE
Rochester, MN 55904-6756
Phone (507) 529-6616

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN, WI2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20050509000232 MN Practitioner - Internal Medicine 0840230918 Reassigns benefits to 3 organizations
I20121211000328 WI Practitioner - Internal MedicinePractitioner - Hospitalist 0840230918 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Mayo Medical School, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Group Health IncGroup PAC ID 1759293954, 1,627 clinicians

Practice addresses (Care Compare)

2831 Snelling N Ave
Roseville, MN 55113-2460
Phone (651) 636-4525

640 Jackson St
Saint Paul, MN 55101-2502
Phone (651) 221-3456

8600 Nicollet Ave
Bloomington, MN 55420-2824
Phone (952) 884-1148

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of nail tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
46577MNMDClinical Pathology/Laboratory Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Amery Regional Medical Center, Inc. CurrentSince Jan 1, 2018 Accepting new patients
Amery Regional Medical Center, Inc. CurrentSince Dec 31, 2025 Accepting new patients
Healthpartners RC CurrentSince Jul 1, 2022 Accepting new patients
Healthpartners RC CurrentSince Jul 1, 2022 Accepting new patients
Group Health, Inc. Current Accepting new patients
Amery Regional Medical Center, Inc. CurrentSince Jan 1, 2018 Accepting new patients
Group Health, Inc. CurrentSince Aug 1, 2012 Accepting new patients
Group Health Plan, Inc. CurrentSince Aug 1, 2012 Accepting new patients
Regions Hospital Past Accepting new patients

Locations

2220 Riverside Ave
Minneapolis, MN 55454
Phone (612) 371-1600

8170 33rd Ave S
#21110Q
Minneapolis, MN 55425
Phone (952) 883-5375

8170 33rd Ave S
Stop 21110Q
Minneapolis, MN 55425

8600 Nicollet Ave S
Minneapolis, MN 55420
Phone (952) 887-6600

100 Healthy Way
Olivia, MN 56277
Phone (320) 523-1261

640 Jackson St
Saint Paul, MN 55101
Phone (651) 221-2164

265 Griffin St E
Amery, WI 54001
Phone (715) 268-0308

405 Stageline Rd
Hudson, WI 54016
Phone (715) 531-6000

Organizations & group practices 9

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 8

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": "1160956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1720168537",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1309",
            "address_2": "MS 21110Q",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554401309",
            "telephone_number": "651-254-3456",
            "fax_number": "651-254-9673"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "640 JACKSON ST",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551012502",
            "telephone_number": "651-254-3456",
            "fax_number": "651-254-9673"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "210 9th St SE",
            "address_purpose": "LOCATION",
            "city": "Rochester",
            "state": "MN",
            "postal_code": "559046756",
            "country_code": "US",
            "telephone_number": "507-529-6616",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "210 9th St SE",
            "address_purpose": "LOCATION",
            "city": "Rochester",
            "state": "MN",
            "postal_code": "559046756",
            "country_code": "US",
            "telephone_number": "507-529-6616",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LARSEN",
        "first_name": "AMY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-16",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0105X",
            "taxonomy_group": "",
            "desc": "Pathology, Clinical Pathology/Laboratory Medicine",
            "state": "MN",
            "license": "46577",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MN",
            "license": "46577",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Paul, MN

Sources for this page

Verify at the official NPI Registry.