NPIMap

Individual provider Active NPI

Lars P Andersen Jr., D.O.

  • Family Medicine Physician
  • Saint Johns, MI
National Provider Identifier
1902835309
Registry record updated Aug 11, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
5101006728 Issued in MI
Practice address
1005 S US Highway 27
Suite 100
Saint Johns, MI 48879-2423
Phone
(989) 224-3000
Fax
(989) 224-1424
NPI assigned
Jun 30, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 5101006728 MI Primary

Addresses

Primary practice location

1005 S US Highway 27
Suite 100
Saint Johns, MI 48879-2423

Mailing address

1005 S US Highway 27
Suite 100
Saint Johns, MI 48879-2423
Phone (989) 224-3000

Other identifiers 2

IdentifierTypeStateIssuer
3026510MedicaidMI
CE4044OtherMIRAILROAD MEDICARE B

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20100126000392 MI Practitioner - Family Practice 6305731993 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
At Still University of Health Sciences, College of Osteo Med, Kirksville, 1974
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Clinton County Medical Center PCGroup PAC ID 8224923818, 27 clinicians

Practice addresses (Care Compare)

1005 S US Hwy 27
Suite 100
Saint Johns, MI 48879-2423
Phone (989) 224-3000

Hospital & facility affiliations

  • University of Michigan Health- Sparrow Clinton Hospital, Saint Johns, MI, CCN 231326
  • Edward W Sparrow Hospital Hospital, Lansing, MI, CCN 230230
  • McLaren Greater Lansing Hospital, Lansing, MI, CCN 230167
  • University of Michigan Health-Sparrow Carson Hospital, Carson City, MI, CCN 230208

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions11
Removal of nail tissue1-10
Skin biopsy1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Outpatient Urgent Care Healthcenter CurrentSince Nov 1, 2025 Accepting new patients
Edward W Sparrow Hospital Association Family Medicine Past Accepting new patients

Locations

10673 E Carson City Rd
Carson City, MI 48811
Phone (989) 584-3153

4185 E Grand River Ave
Howell, MI 48843
Phone (517) 546-9200

1005 S US Highway 27
Ste 100
Saint Johns, MI 48879
Phone 9892243000616

1005 S US Highway 27
Ste 200
Saint Johns, MI 48879
Phone (989) 224-6897

1005 S US Highway 27
#100
Saint Johns, MI 48879

Interoperability endpoints

  • Direct secure messaging: larsandersen@ccmedc.allscriptsdirect.net

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 and National Provider Directory roles.

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": "1151625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1470873600000",
    "number": "1902835309",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1005 S US HIGHWAY 27",
            "address_2": "SUITE 100",
            "city": "SAINT JOHNS",
            "state": "MI",
            "postal_code": "488792423",
            "telephone_number": "989-224-3000",
            "fax_number": "989-224-1424"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1005 S US HIGHWAY 27",
            "address_2": "SUITE 100",
            "city": "SAINT JOHNS",
            "state": "MI",
            "postal_code": "488792423",
            "telephone_number": "989-224-3000",
            "fax_number": "989-224-1424"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSEN",
        "first_name": "LARS",
        "middle_name": "P",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-30",
        "last_updated": "2016-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "5101006728",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3026510",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE B",
            "identifier": "CE4044",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Johns, MI

Sources for this page

Verify at the official NPI Registry.