Keith Larson, PA-C

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

5601002740 Issued in MI

Practice address

3901 Beaubien St
Detroit, MI 48201-2119

Phone

(313) 745-5437

NPI assigned

Mar 29, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI, WA2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: klarson602264@direct.hfhs.org
• Direct secure messaging: klarson153521@direct.seattlechildrens.org

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.

• Henry Ford Macomb Hospital Corporation

  • Family Medicine Physician
  • Clinton TWP, MI
  • NPI 1134265986
  Medicare reassignment NPD
• The Association of Chrmc and University Physicians

  • Pediatrics Physician
  • Seattle, WA
  • NPI 1255449963
  Medicare reassignment NPD
• VHS Physicians of Michigan

  • Internal Medicine Physician
  • Southfield, MI
  • NPI 1073827101
  Medicare reassignment
• Seattle Children'S Hospital

  • Specialist
  • Seattle, WA
  • NPI 1003319500
  Medicare reassignment
• Henry Ford Macomb Hospital Corporation

  • General Acute Care Hospital
  • Clinton TWP, MI
  • NPI 1023114634
  NPD
• Association of CHMC and University Physicians

  • Pediatrics Physician
  • Richland, WA
  • NPI 1851680664
  NPD
• Seattle Childrens Hospital

  • Clinic Pharmacy
  • Seattle, WA
  • NPI 1245342153
  NPD
• DMC Orthopedic Billing Associates LLC

  • Orthopaedic Surgery Physician
  • Detroit, MI
  • NPI 1457387607
  NPD (past)
• Seattle Children'S Hospital

  • Home Infusion Agency
  • Bothell, WA
  • NPI 1245383348
  NPD (past)

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

{
    "created_epoch": "1175126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1912027772",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3901 BEAUBIEN CHM DEPT OF CARDIOVASCULAR SURGERY",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "48201",
            "telephone_number": "313-745-5538"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3901 BEAUBIEN ST",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482012119",
            "telephone_number": "313-745-5437"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LARSON",
        "first_name": "KEITH",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-29",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "MI",
            "license": "5601002740",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Larry Weiss DPM PC
• Stanley Larry
• Lynn Larsen, LLMSW
• Allison Shin Larson
• Elyza Larson, MD
• Nathaniel David Larson
• Paulette Maria Lasalle, RN CNP
• Angela Valentina Lasek, LMSW
• Dana Raquel Lasenby, MA, LLP
• Shanna Lasker, LMSW

• Surgical Physician Assistant in Detroit, MI
• Providers in Detroit, MI by specialty
• Surgical Physician Assistant in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.