Individual provider Active NPI

Siri Zirkle Larsen, CRNP

  • Family Nurse Practitioner
  • Philadelphia, PA
National Provider Identifier
1902392012
Registry record updated Jul 2, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
SP018404 Issued in PA
Practice address
925 Chestnut St
Philadelphia, PA 19107-4216
Phone
(215) 955-8199
NPI assigned
Jul 2, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 2, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X SP018404 PA Primary

Addresses

Primary practice location

925 Chestnut St
Philadelphia, PA 19107-4216

Mailing address

7318 Bingham St
Philadelphia, PA 19111-3614
Phone (215) 380-4118

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190805000225 PA Practitioner - Nurse Practitioner 6103153853 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1300 Wolf St
1St Floor
Philadelphia, PA 19148-2912

615 Chestnut St
Philadelphia, PA 19106-4404

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Jefferson University Physicians CurrentSince May 25, 2019 Accepting new patients
Jefferson University Physicians Past Accepting new patients

Locations

1300 Wolf St
Fl 1
Philadelphia, PA 19148
Phone (215) 551-0360

925 Chestnut St
Fl 6
Philadelphia, PA 19107
Phone (215) 955-6760

925 Chestnut St
Ste Mezzanine
Philadelphia, PA 19107

1300 Wolf St
Philadelphia, PA 19148
Phone (215) 952-1428

1101 Chestnut St
#8
Philadelphia, PA 19107
Phone (215) 955-5869

925 Chestnut St
Philadelphia, PA 19107
Phone (215) 955-5050

925 Chestnut St
Fl 4
Philadelphia, PA 19107
Phone (215) 955-5772

111 S 11th St
Philadelphia, PA 19107
Phone (215) 955-6161

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1530489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1530489600000",
    "number": "1902392012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7318 BINGHAM ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191113614",
            "telephone_number": "215-380-4118"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "925 CHESTNUT ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191074216",
            "telephone_number": "215-955-8199"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LARSEN",
        "first_name": "SIRI",
        "middle_name": "ZIRKLE",
        "credential": "CRNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-07-02",
        "last_updated": "2018-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "PA",
            "license": "SP018404",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.