Individual provider Active NPI

Steven S Larson, M.D.

  • Surgery Physician
  • El Paso, TX
National Provider Identifier
1861440653
Registry record updated Feb 8, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
G5281 Issued in TX
Practice address
5959 Gateway Blvd W
Suite 120
El Paso, TX 79925-3331
Phone
(915) 779-1716
Fax
(915) 779-1754
NPI assigned
May 4, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 8, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X G5281 TX Primary

Addresses

Primary practice location

5959 Gateway Blvd W
Suite 120
El Paso, TX 79925-3331

Mailing address

1201 E Schuster Ave
Building 4B
El Paso, TX 79902-4672
Phone (915) 351-9200

Other identifiers 1

IdentifierTypeStateIssuer
120292105MedicaidTX

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070905000360 TX Practitioner - General Surgery 1850495466 Practice locations: El Paso, TX

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G5281TXMDSurgery Physician

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1146700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1297123200000",
    "number": "1861440653",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1201 E SCHUSTER AVE",
            "address_2": "BUILDING 4B",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799024672",
            "telephone_number": "915-351-9200",
            "fax_number": "915-351-9266"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5959 GATEWAY BLVD W",
            "address_2": "SUITE 120",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799253331",
            "telephone_number": "915-779-1716",
            "fax_number": "915-779-1754"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LARSON",
        "first_name": "STEVEN",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-04",
        "last_updated": "2011-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "TX",
            "license": "G5281",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "120292105",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in El Paso, TX

Sources for this page

Verify at the official NPI Registry.