Timothy L Larson, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

0386 Issued in SD

Practice address

1401 Nwakama St
Marshall, MN 56258-5529

Phone

(507) 929-7696

Fax

(507) 393-7697

NPI assigned

Jun 23, 2006

Last updated

Oct 31, 2011By the provider in NPPES

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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MN, SD2 enrollments

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 2

Specialty

Physician Assistant

Education

Other, 1997

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Hospital & facility affiliations

• Prairie Lakes Healthcare System, Inc Hospital, Watertown, SD, CCN 430005

Merit-based Incentive Payment System (MIPS)

Final score

94.59 of 100Reported as group

Quality

100

Promoting interoperability

96

Improvement activities

40

Cost

85.3

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Physician Assistant

State licenses

Practice roles

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.

• Prairie Lakes Health Care System Inc

  dba Sanford Watertown Specialty Clinic

  • Rural Acute Care Hospital
  • Watertown, SD
  • NPI 1720166002
  Medicare reassignment
• Aberdeen Asthma & Allergy PC

  • Allergy & Immunology Physician
  • Aberdeen, SD
  • NPI 1578882387
  NPD (past)

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

{
    "created_epoch": "1151020800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1320019200000",
    "number": "1982630828",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1401 NWAKAMA ST",
            "city": "MARSHALL",
            "state": "MN",
            "postal_code": "562585529",
            "telephone_number": "507-929-7696",
            "fax_number": "507-393-7697"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 NWAKAMA ST",
            "city": "MARSHALL",
            "state": "MN",
            "postal_code": "562585529",
            "telephone_number": "507-929-7696",
            "fax_number": "507-393-7697"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LARSON",
        "first_name": "TIMOTHY",
        "middle_name": "L",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-23",
        "last_updated": "2011-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "SD",
            "license": "0386",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6826122",
            "state": "SD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Vincent D Laporte, MD
• Andrew Larsen
• Heidi Larsen, CCC-SLP
• Michael A Larson, LICSW
• Renee Larson, ADT
• Lastine Chiropractic PC
• Anna Josephine Latza-Oberster, OD
• Morgan Hoffbeck Lavoy
• Gregory Gayle Lecy, DDS
• Miranda Nichole Lee

• Physician Assistant in Marshall, MN
• Providers in Marshall, MN by specialty
• Physician Assistant in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2011; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.