Individual provider Active NPI

David Fernando Frugone Larrea, M.D.

  • Geriatric Medicine (Internal Medicine) Physician
  • Crookston, MN
National Provider Identifier
1902037377
Registry record updated May 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Internal Medicine) PhysicianTaxonomy code 207RG0300X
License
MD60969350 Issued in WA
Practice address
400 South Minnesota Street
Crookston, MN 56716
Phone
(218) 281-9100
NPI assigned
Aug 4, 2009
Last updated
May 18, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 18, 2021

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

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 107390 MN
Internal Medicine Physician 207R00000X 125.056815 IL
Internal Medicine Physician 207R00000X MD60969350 WA
Internal Medicine Physician 207R00000X 036.129998 IL
Geriatric Medicine (Internal Medicine) Physician 207RG0300X 036.129998 IL
Geriatric Medicine (Internal Medicine) Physician 207RG0300X MD60969350 WA Primary

Addresses

Primary practice location

400 South Minnesota Street
Crookston, MN 56716

Mailing address

550 Gage Blvd
Ste 101
Richland, WA 99352-9532
Phone (509) 942-3627

Other practice location 1

911 S Washington St
Kennewick, WA 99336-5600
Phone (509) 942-2288

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address dfrugonelarrea1157235@wm.providencedirect.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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
I20191013000040 WA Practitioner - Geriatric MedicinePractitioner - Internal Medicine 2264664820 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Geriatric MedicineAlso: Internal Medicine
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Kadlec Regional Medical CenterGroup PAC ID 9739098617, 402 clinicians

Practice addresses (Care Compare)

911 S Washington St
Kennewick, WA 99336-5600
Phone (509) 942-2288

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
125.056815ILMDInternal Medicine Physician
036.129998ILMDGeriatric Medicine (Internal Medicine) Physician
MD60969350WAMDGeriatric Medicine (Internal Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Kadlec Regional Medical Center CurrentSince Sep 30, 2019 Accepting new patients
Kadlec Regional Medical Center CurrentSince Sep 30, 2019 Accepting new patients
Kadlec Regional Medical Center Internal Medicine Current Accepting new patients

Locations

911 S Washington St
Kennewick, WA 99336
Phone (509) 586-2828

1135 Jadwin Ave
Richland, WA 99352
Phone (509) 942-3300

550 Gage Blvd
Ste 101
Richland, WA 99352

888 Swift Blvd
Richland, WA 99352
Phone (509) 942-2115

Organizations & group practices 3

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 5

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": "1249344000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621296000000",
    "number": "1902037377",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "550 GAGE BLVD",
            "address_2": "STE 101",
            "city": "RICHLAND",
            "state": "WA",
            "postal_code": "993529532",
            "telephone_number": "509-942-3627",
            "fax_number": "509-627-2983"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 SOUTH MINNESOTA STREET",
            "city": "CROOKSTON",
            "state": "MN",
            "postal_code": "56716",
            "telephone_number": "218-281-9100"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "911 S Washington St",
            "address_purpose": "LOCATION",
            "city": "Kennewick",
            "state": "WA",
            "postal_code": "993365600",
            "country_code": "US",
            "telephone_number": "509-942-2288",
            "fax_number": "509-585-6116",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FRUGONE LARREA",
        "first_name": "DAVID",
        "middle_name": "FERNANDO",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-08-04",
        "last_updated": "2021-05-18",
        "certification_date": "2021-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MN",
            "license": "107390",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "125.056815",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WA",
            "license": "MD60969350",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036.129998",
            "primary": false
        },
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "IL",
            "license": "036.129998",
            "primary": false
        },
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "WA",
            "license": "MD60969350",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dfrugonelarrea1157235@wm.providencedirect.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "911 S Washington St",
            "city": "Kennewick",
            "state": "WA",
            "country_code": "US",
            "postal_code": "993365600",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Crookston, MN

Sources for this page

Verify at the official NPI Registry.