Active NPI
Peter G Larcom, MD
- Adult Reconstructive Orthopaedic Surgery Physician
- Murray, UT
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Adult Reconstructive Orthopaedic Surgery Physician
- License
- 321930-1205
- Practice address
- 5316 S Woodrow St Ste 200
Murray, UT 84107-5838 - Phone
- (801) 747-1020
- Fax
- (801) 747-1023
- NPI assigned
- Jul 6, 2006
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Adult Reconstructive Orthopaedic Surgery Physician | 207XS0114X | 321930-1205 | UT | Primary |
Addresses
Primary practice location
5316 S Woodrow St Ste 200
Murray, UT 84107-5838
Mailing address
5316 S Woodrow St Ste 200
Murray, UT 84107-5838
Phone (801) 747-1020
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in UT
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20040818000346 | UT | Practitioner - Orthopedic Surgery | 3274506118 | Reassigns benefits to 2 organizations |
Care Compare profile
Medicare Care Compare- Specialty
- Orthopedic Surgery
- Education
- Tufts University School of Medicine, 1989
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Ihc Health Services Inc
Practice addresses (Care Compare)
5121 S Cottonwood St
Murray, UT 84107-5701
5316 S Woodrow St
Suite 200
Murray, UT 84107-5479
Phone (801) 747-1020
8 TH Ave and C St
LDS Hosp Eeg Phys GRP
Salt Lake City, UT 84143
Phone (801) 507-7000
Hospital & facility affiliations
- Intermountain Homecare Home Health Salt Lake
- Intermountain Medical Center
- St Mark'S Hospital
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Hip replacement | 1-10 |
| Knee replacement | 1-10 |
| Upper limb (arm) arthroscopy (minimally invasive joint repair) | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 321930-1205 | UT | MD | Adult Reconstructive Orthopaedic Surgery Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ihc Health Services Inc | Current | Accepting new patients | |
| Ihc Health Services, Inc. | Current | Accepting new patients | |
| Peter G. Larcom MD PC | Adult Reconstructive Orthopaedic Surgery | Current | Accepting new patients |
| Ihc Health Services Inc | Current | Accepting new patients |
Locations
700 S Highway 99
Ste 3
Fillmore, UT 84631
Phone (435) 743-5555
5316 S Woodrow St
Ste 200
Salt Lake City, UT 84107
Phone (801) 747-1020
5121 S Cottonwood St
Salt Lake Cty, UT 84107
Phone (801) 408-8998
400 C St
Salt Lake Cty, UT 84143
Phone (435) 688-4080
440 D St
#206
Slc, UT 84103
Phone (801) 408-2900
Interoperability endpoints
- peter.larcom.1@30853.direct.athenahealth.com
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.
-
- Adult Reconstructive Orthopaedic Surgery Physician
- Murray, UT
- NPI 1326286972
Adult Reconstructive Orthopaedic Surgery, UT
-
- Multi-Specialty Clinic/Center
- Murray, UT
- NPI 1710200373
-
- Psychiatry Physician
- St George, UT
- NPI 1023843844
Hospital & facility affiliations 3
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Home Health Agency
- South Jordan, UT
- NPI 1447344098
-
- General Acute Care Hospital
- Salt Lake City, UT
- NPI 1164469243
Hospital
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152144000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1546473600000",
"number": "1821029869",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5316 S WOODROW ST STE 200",
"city": "MURRAY",
"state": "UT",
"postal_code": "841075838",
"telephone_number": "801-747-1020",
"fax_number": "801-747-1023"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5316 S WOODROW ST STE 200",
"city": "MURRAY",
"state": "UT",
"postal_code": "841075838",
"telephone_number": "801-747-1020",
"fax_number": "801-747-1023"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LARCOM",
"first_name": "PETER",
"middle_name": "G",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-07-06",
"last_updated": "2019-01-03",
"status": "A"
},
"taxonomies": [
{
"code": "207XS0114X",
"taxonomy_group": "",
"desc": "Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery",
"state": "UT",
"license": "321930-1205",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Murray, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 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.