NPIMap

Individual provider Active NPI

Michael Lagrande Larsen, MD

  • Diagnostic Radiology Physician
  • Coeur D Alene, ID
National Provider Identifier
1902005663
Registry record updated Jun 1, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
M-12071 Issued in ID
Practice address
700 W Ironwood Dr Ste 175
Coeur D Alene, ID 83814-4401
Phone
(208) 625-6300
Fax
(208) 625-6301
NPI assigned
Jul 13, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 1, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X M-12071 ID Primary

Addresses

Primary practice location

700 W Ironwood Dr Ste 175
Coeur D Alene, ID 83814-4401

Mailing address

700 W Ironwood Dr Ste 175
Coeur D Alene, ID 83814-4401
Phone (208) 625-6309

Other practice location 1

1300 E Mullan Ave Ste 700
Post Falls, ID 83854-6054
Phone (208) 625-5564

Other practice location 2

25 Jacobs Gulch Rd
Kellogg, ID 83837-2023
Phone (208) 784-1221

Other practice location 3

2003 Kootenai Health Way
Coeur D Alene, ID 83814-6051
Phone (208) 625-6360

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mlarsen627549@direct.multicare.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID
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
I20130723001013 ID Practitioner - Diagnostic Radiology 2769559228 Reassigns benefits to 11 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Oregon Health Sciences University School of Medicine, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kootenai Health IncGroup PAC ID 1355792276, 394 clinicians
Radiology Associates of North Idaho PAGroup PAC ID 4385635150, 32 clinicians
Benewah Community HospitalGroup PAC ID 1850200700, 39 clinicians
Bonner General Hospital IncGroup PAC ID 4082690466, 47 clinicians
Boundary Community HospitalGroup PAC ID 3274583406, 29 clinicians

Practice addresses (Care Compare)

1055 Riverside Ave
Orofino, ID 83544-9029
Phone (208) 476-5777

1300 E Mullan Ave
Post Falls, ID 83854-6054

1300 E Mullan Ave
Suite 1300
Post Falls, ID 83854-6057
Phone (208) 625-5630

2003 Kootenai Health Way
Coeur D Alene, ID 83814-6051
Phone (208) 625-6360

229 S 7TH St
St Maries, ID 83861-1803
Phone (208) 245-5551

423 N 3Rd Ave
Sandpoint, ID 83864-1511

520 N 3Rd Ave
Sandpoint, ID 83864-1507
Phone (208) 263-0649

6640 Kaniksu St
Bonners Ferry, ID 83805-7532
Phone (208) 267-3141

Hospital & facility affiliations

  • Kootenai Health Hospital, Coeur D'Alene, ID, CCN 130049
  • Bonner General Hospital Hospital, Sandpoint, ID, CCN 131328
  • Benewah Community Hospital Hospital, Saint Maries, ID, CCN 131317
  • St Joseph Regional Medical Center Hospital, Lewiston, ID, CCN 130003
  • Boundary Community Hospital Hospital, Bonners Ferry, ID, CCN 131301

Merit-based Incentive Payment System (MIPS)

Final score
86.65 of 100Reported as apm
Quality
89.26
Promoting interoperability
69.9
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
86.65 of 100Reported as apm
Quality
89.26
Promoting interoperability
69.9
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Incyte Pathology, PLLC Current Accepting new patients
Kootenai Health, Inc. Current Accepting new patients
Kootenai Health, Inc. CurrentSince Jan 1, 2024 Accepting new patients
Benewah Community Hospital Current Accepting new patients
Radiology Associates of North Idaho, PA Diagnostic Radiology CurrentSince Jul 1, 2013 Accepting new patients
Boundary Community Hospital CurrentSince Aug 1, 2013 Accepting new patients
Kootenai Health, Inc. CurrentSince Jan 1, 2024 Accepting new patients
Kootenai Health, Inc. CurrentSince Jun 16, 2018 Accepting new patients
Bonner General Hospital, Inc CurrentSince Sep 1, 2015 Accepting new patients
Boundary Community Hospital CurrentSince Aug 1, 2013 Accepting new patients
Bonner General Hospital Inc. CurrentSince Jul 28, 2015 Accepting new patients
Benewah Community Hospital Diagnostic Radiology CurrentSince Aug 25, 2015 Accepting new patients
Shoshone Medical Center Past Accepting new patients
Boundary Community Hospital Diagnostic Radiology Past Accepting new patients
Mayo Clinic Past Accepting new patients

Locations

6640 Kaniksu St
Bonners Ferry, ID 83805
Phone (208) 267-3141

700 W Ironwood Dr
Ste 110
Coeur D Alene, ID 83814
Phone (208) 666-3200

2003 Kootenai Health Way
Coeur D Alene, ID 83814
Phone (208) 625-5085

700 W Ironwood Dr
Ste 175
Coeur D Alene, ID 83814
Phone (208) 625-6300

25 Jacobs Gulch Rd
Kellogg, ID 83837
Phone (208) 784-1221

1300 E Mullan Ave
Ste 700
Post Falls, ID 83854
Phone (208) 625-5564

520 N Third Ave
Sandpoint, ID 83864
Phone (208) 263-0649

423 N Third Ave
Ste 210
Sandpoint, ID 83864
Phone (208) 263-1441

229 S 7th St
St Maries, ID 83861
Phone (208) 245-2591

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/e8b4f872-6ea1-4b26-a974-041b5fb4c57b/
  • FHIR API: https://fhir-myrecord.cerner.com/r4/9a0a9763-cc6e-4ca0-bdec-c16291c965b9/
  • Direct secure messaging: mlarsen627549@direct.multicare.org

Organizations & group practices 19

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.

View all 19

Hospital & facility affiliations 6

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": "1184284800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780272000000",
    "number": "1902005663",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 W IRONWOOD DR STE 175",
            "city": "COEUR D ALENE",
            "state": "ID",
            "postal_code": "838144401",
            "telephone_number": "208-625-6309",
            "fax_number": "208-625-6310"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 W IRONWOOD DR STE 175",
            "city": "COEUR D ALENE",
            "state": "ID",
            "postal_code": "838144401",
            "telephone_number": "208-625-6300",
            "fax_number": "208-625-6301"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1300 E Mullan Ave Ste 700",
            "address_purpose": "LOCATION",
            "city": "Post Falls",
            "state": "ID",
            "postal_code": "838546054",
            "country_code": "US",
            "telephone_number": "208-625-5564",
            "fax_number": "208-625-5565",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "25 Jacobs Gulch Rd",
            "address_purpose": "LOCATION",
            "city": "Kellogg",
            "state": "ID",
            "postal_code": "838372023",
            "country_code": "US",
            "telephone_number": "208-784-1221",
            "fax_number": "208-784-0961",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2003 Kootenai Health Way",
            "address_purpose": "LOCATION",
            "city": "Coeur D Alene",
            "state": "ID",
            "postal_code": "838146051",
            "country_code": "US",
            "telephone_number": "208-625-6360",
            "fax_number": "208-625-6361",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LARSEN",
        "first_name": "MICHAEL",
        "middle_name": "LAGRANDE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-07-13",
        "last_updated": "2026-06-01",
        "certification_date": "2026-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "ID",
            "license": "M-12071",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mlarsen627549@direct.multicare.org",
            "affiliation": "N",
            "address_1": "1300 E Mullan Ave Ste 700",
            "city": "Post Falls",
            "state": "ID",
            "country_code": "US",
            "postal_code": "838546054",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Coeur D Alene, ID

Sources for this page

Verify at the official NPI Registry.