NPIMap

Individual provider Active NPI

Mary Stella Larson, M.D.

  • Cardiovascular Disease Physician
  • Redwood City, CA
National Provider Identifier
1982650040
Registry record updated Jul 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
G76435 Issued in CA
Practice address
2900 Whipple Ave
Suite 230
Redwood City, CA 94062-2843
Phone
(650) 306-2300
Fax
(650) 306-2336
NPI assigned
May 26, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X M-15598 ID
Cardiovascular Disease Physician 207RC0000X G76435 CA Primary

Addresses

Primary practice location

2900 Whipple Ave
Suite 230
Redwood City, CA 94062-2843

Mailing address

3400 Data Drive
Rancho Cordova, CA 95670

Other practice location 1

700 W Ironwood Dr Ste 350
Coeur D Alene, ID 83814-4487
Phone (208) 625-5250

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID
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
I20230217001262 ID Practitioner - Cardiovascular Disease (Cardiology) 7214020544 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
Other, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kootenai Health IncGroup PAC ID 1355792276, 394 clinicians

Practice addresses (Care Compare)

1055 Riverside Ave
Orofino, ID 83544-9029
Phone (208) 476-5777

1300 E Mullan Ave
Suite 1300
Post Falls, ID 83854-6057
Phone (208) 625-5630

1701 Lincoln Way
Coeur D Alene, ID 83814-2537
Phone (208) 625-4900

1919 Lincoln Way
Coeur D Alene, ID 83814-2527

2003 Kootenai Health Way
Coeur D Alene, ID 83814-6051

423 N 3Rd Ave
Suite 355
Sandpoint, ID 83864-1511
Phone (208) 263-2505

566 W Prairie Ave
Coeur D Alene, ID 83815-7766
Phone (208) 625-5155

6640 Kaniksu St
Bonners Ferry, ID 83805-7532
Phone (208) 267-3141

700 W Ironwood Dr
Suite 320
Coeur D Alene, ID 83814-4485
Phone (208) 625-5250

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
86.65 of 100Reported as apm
Quality
89.26
Promoting interoperability
69.9
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Pacemaker insertion or repair1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G76435CAMDCardiovascular Disease Physician
M-15598IDMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Boundary Community Hospital Cardiovascular Disease CurrentSince Nov 1, 2023 Accepting new patients
Kootenai Health, Inc. CurrentSince Feb 9, 2023 Accepting new patients
Incyte Pathology, PLLC Current Accepting new patients
Kootenai Health, Inc. CurrentSince Jan 1, 2024 Accepting new patients
Kootenai Health, Inc. CurrentSince Jan 1, 2024 Accepting new patients
Kootenai Health, Inc. Current Accepting new patients
Kootenai Health, Inc. CurrentSince Feb 9, 2023 Accepting new patients
Boundary Community Hospital Current Accepting new patients
Boundary Community Hospital CurrentSince Nov 1, 2023 Accepting new patients

Locations

6640 Kaniksu St
Bonners Ferry, ID 83805
Phone (208) 267-3141

2003 Kootenai Health Way
Coeur D Alene, ID 83814
Phone (208) 625-5085

700 W Ironwood Dr
Ste 320
Coeur D Alene, ID 83814
Phone (208) 625-5250

700 W Ironwood Dr
Ste 350
Coeur D Alene, ID 83814
Phone (208) 625-5222

1300 E Mullan Ave
Ste 700
Post Falls, ID 83854
Phone (208) 625-5564

Organizations & group practices 9

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 15

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1148601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753228800000",
    "number": "1982650040",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3400 DATA DRIVE",
            "city": "RANCHO CORDOVA",
            "state": "CA",
            "postal_code": "95670"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2900 WHIPPLE AVE",
            "address_2": "SUITE 230",
            "city": "REDWOOD CITY",
            "state": "CA",
            "postal_code": "940622843",
            "telephone_number": "650-306-2300",
            "fax_number": "650-306-2336"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "700 W Ironwood Dr Ste 350",
            "address_purpose": "LOCATION",
            "city": "Coeur D Alene",
            "state": "ID",
            "postal_code": "838144487",
            "country_code": "US",
            "telephone_number": "208-625-5250",
            "fax_number": "208-625-5251",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LARSON",
        "first_name": "MARY",
        "middle_name": "STELLA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-26",
        "last_updated": "2025-07-23",
        "certification_date": "2025-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "ID",
            "license": "M-15598",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "CA",
            "license": "G76435",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Redwood City, CA

Sources for this page

Verify at the official NPI Registry.