NPIMap

Individual provider Active NPI

Larry Walter Anderson, MD

  • Anatomic Pathology & Clinical Pathology Physician
  • Des Moines, IA
National Provider Identifier
1891803979
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
28786 Issued in IA
Practice address
1212 Pleasant
#LL3
Des Moines, IA 50309-1414
Phone
(515) 241-8866
Fax
(515) 241-8855
NPI assigned
Aug 28, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 28786 IA Primary

Addresses

Primary practice location

1212 Pleasant
#LL3
Des Moines, IA 50309-1414

Mailing address

1212 Pleasant
#LL3
Des Moines, IA 50309-1414
Phone (515) 241-8866

Other identifiers 1

IdentifierTypeStateIssuer
6085183MedicaidIA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070402000546 IA Practitioner - Pathology 3173627023 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
Northwestern University Feinberg Medical School, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Regional Laboratory Consultants PCGroup PAC ID 6901709062, 12 clinicians

Practice addresses (Care Compare)

1200 Pleasant St
Des Moines, IA 50309-1406
Phone (515) 241-8861

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
92.56 of 100Reported as group
Quality
81.02
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
28786IAMDAnatomic Pathology & Clinical Pathology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Broadlawns Medical Center CurrentSince May 22, 2012 Accepting new patients
St Luke's Methodist Hospital Current Accepting new patients
Iowa Pathology Associates PC Current Accepting new patients
Broadlawns Medical Center Current Accepting new patients
Broadlawns Medical Center CurrentSince May 22, 2012 Accepting new patients
Regional Laboratory Consultants PC Anatomic Pathology & Clinical Pathology CurrentSince Jan 1, 1995 Accepting new patients

Locations

1200 Pleasant St
Des Moines, IA 50309
Phone (515) 241-5926

1200 Pleasant St
Ste LL3
Des Moines, IA 50309

1212 Pleasant St
Ste LL3
Des Moines, IA 50309
Phone (515) 241-8861

1801 Hickman Rd
Des Moines, IA 50314
Phone (515) 282-2200

1801 Hickman Rd
Ofc
Des Moines, IA 50314

700 E University Ave
Des Moines, IA 50316
Phone (515) 263-5120

Interoperability endpoints

  • Direct secure messaging: landerson12301@direct.unitypoint.org

Organizations & group practices 6

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 3

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": "1156723200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1891803979",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1212 PLEASANT",
            "address_2": "#LL3",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503091414",
            "telephone_number": "515-241-8866",
            "fax_number": "515-241-8855"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1212 PLEASANT",
            "address_2": "#LL3",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503091414",
            "telephone_number": "515-241-8866",
            "fax_number": "515-241-8855"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "LARRY",
        "middle_name": "WALTER",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-28",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "IA",
            "license": "28786",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6085183",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Des Moines, IA

Sources for this page

Verify at the official NPI Registry.