Individual provider Active NPI

Larissa Oberlander, PA

  • Physician Assistant
  • Meadville, PA
National Provider Identifier
1730812512
Registry record updated Jun 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
MA063691 Issued in PA
Practice address
11277 Vernon PL Ste 200
Meadville, PA 16335-3719
Phone
(814) 724-1252
Fax
(814) 333-8871
NPI assigned
Jul 8, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X MA063691 PA Primary

Addresses

Primary practice location

11277 Vernon PL Ste 200
Meadville, PA 16335-3719

Mailing address

11277 Vernon PL Ste 200
Meadville, PA 16335-3719
Phone (814) 724-1252

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20220825001198 PA Practitioner - Physician Assistant 1951785906 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Novacare Outpatient Rehabilitation East, Inc.Group PAC ID 3678480290, shared by 15 NPIs, 493 clinicians
Orthopedic Associates of Meadville, P.C.Group PAC ID 0446151864, 17 clinicians
Keystone Rehabilitation Systems IncGroup PAC ID 7012826753, shared by 15 NPIs, 750 clinicians

Practice addresses (Care Compare)

1012 Water St
Meadville, PA 16335-3468
Phone (814) 337-2345

11277 Vernon PL
Suite 200
Meadville, PA 16335-3719
Phone (814) 724-1252

316 Allegheny Blvd
Suite B
Franklin, PA 16323-6208
Phone (814) 432-7200

5930 Old French Rd
Erie, PA 16509-3656
Phone (814) 860-7816

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Organizations & group practices 1

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 1

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": "1657238400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719187200000",
    "number": "1730812512",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11277 VERNON PL STE 200",
            "city": "MEADVILLE",
            "state": "PA",
            "postal_code": "163353719",
            "telephone_number": "814-724-1252",
            "fax_number": "814-333-8871"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11277 VERNON PL STE 200",
            "city": "MEADVILLE",
            "state": "PA",
            "postal_code": "163353719",
            "telephone_number": "814-724-1252",
            "fax_number": "814-333-8871"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OBERLANDER",
        "first_name": "LARISSA",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-07-08",
        "last_updated": "2024-06-24",
        "certification_date": "2024-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA063691",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Meadville, PA

Sources for this page

Verify at the official NPI Registry.