Dr Peter Eric Larsen, DDS is a medicare enrolled "Oral & Maxillofacial Surgery" provider in Columbus, Ohio. His current practice location is
305 W 12th Ave, Columbus, Ohio. You can reach out to his office (for appointments etc.) via phone at
(614) 292-5144.
Dr Peter Eric Larsen is licensed to practice in Ohio (license number 30.018614) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1205912300.
Healthcare Provider's Profile
| Full Name | Dr Peter Eric Larsen |
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| Gender | Male |
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| Speciality | Oral & Maxillofacial Surgery |
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| Location | 305 W 12th Ave, Columbus, Ohio |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1205912300
- Provider Enumeration Date: 10/31/2006
- Last Update Date: 12/18/2019
Medicare PECOS Information:
- PECOS PAC ID: 2567640832
- Enrollment ID: I20120227000843
Medical Identifiers
Medical identifiers for Dr Peter Eric Larsen such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1205912300 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | 18614 (Ohio) | Secondary |
| 204E00000X | Oral & Maxillofacial Surgery | 30.018614 (Ohio) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Dr Peter Eric Larsen allows following entities to bill medicare on his behalf.
| Entity Name | Ohio State Dental Faculty Practice Inc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1164537684
PECOS PAC ID: 5496788630
Enrollment ID: O20050916000944 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Peter Eric Larsen is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
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Dr Peter Eric Larsen, DDS
Po Box 182357,
Columbus, OH 43218-2357
Ph: () - | Dr Peter Eric Larsen, DDS
305 W 12th Ave,
Columbus, OH 43210-1267
Ph: (614) 292-5144 |
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