Kyle Luis Larsen, DDS in Trinidad, CO - Medicare Dentist Provider

Kyle Luis Larsen, DDS is a medicare enrolled "Dentist - General Practice" provider in Trinidad, Colorado. His current practice location is 928 Smith Ave, Trinidad, Colorado. You can reach out to his office (for appointments etc.) via phone at (719) 422-8810.

Kyle Luis Larsen is licensed to practice in Colorado (license number DEN.00203245) 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 1386166304.

Contact Information

	Kyle Luis Larsen, DDS
	928 Smith Ave, Trinidad, CO 81082-2841
	(719) 422-8810
	Not Available

Map and Direction

Healthcare Provider's Profile

Full Name	Kyle Luis Larsen
Gender	Male
Speciality	Dentist - General Practice
Location	928 Smith Ave, Trinidad, Colorado
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1386166304
Provider Enumeration Date: 07/11/2017
Last Update Date: 10/28/2020

Medicare PECOS Information:

PECOS PAC ID: 8628495538
Enrollment ID: I20200824001812

Medical Identifiers

Medical identifiers for Kyle Luis Larsen such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1386166304	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
1223G0001X	Dentist - General Practice	DEN.00203245 (Colorado)	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. Kyle Luis Larsen allows following entities to bill medicare on his behalf.

Entity Name	Salud Family Health
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1275530388 PECOS PAC ID: 3173433398 Enrollment ID: O20031126000756

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. Kyle Luis 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
Kyle Luis Larsen, DDS 928 Smith Ave, Trinidad, CO 81082-2841 Ph: (719) 422-8810	Kyle Luis Larsen, DDS 928 Smith Ave, Trinidad, CO 81082-2841 Ph: (719) 422-8810

Reviews and Comments

Dentist in Trinidad, CO

Mr. Daniel Howard Berry, DDS Dentist Medicare: Medicare Enrolled Practice Location: 403 E 1st St, Trinidad, CO 81082 Phone: 719-846-2259 Fax: 719-845-8117
Gary Lane Elsberry, DDS Dentist Medicare: Not Enrolled in Medicare Practice Location: 134 W Main St Ste 34, Trinidad, CO 81082 Phone: 719-846-3371 Fax: 719-846-3372
Parker Theodore Kastelic I, DMD Dentist Medicare: Not Enrolled in Medicare Practice Location: 2124 Freedom Rd, Trinidad, CO 81082 Phone: 719-422-5696
Dr. Paul A Andreatta, D.D.S. P.C. Dentist Medicare: Medicare Enrolled Practice Location: 1723 E Main St, Trinidad, CO 81082 Phone: 719-846-4028 Fax: 719-845-0097
Dr. Brian Nazeri, DDS Dentist Medicare: Not Enrolled in Medicare Practice Location: 209 E Main St, Trinidad, CO 81082 Phone: 719-846-0870
Dr. Steven David Blohm, DDS Dentist Medicare: Not Enrolled in Medicare Practice Location: 209 E Main, Trinidad, CO 81082 Phone: 719-846-0870

Kyle Luis Larsen, DDS - Medicare Dentist in Trinidad, CO