Dr Terry Lee Larsen, DO is a medicare enrolled "Surgery" physician in St Johnsbury, Vermont. His current practice location is
1315 Hospital Dr, St Johnsbury, Vermont. You can reach out to his office (for appointments etc.) via phone at
(802) 748-8141.
Dr Terry Lee Larsen is licensed to practice in Vermont (license number 032.0066383) 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 1144340712.
Physician's Profile
| Full Name | Dr Terry Lee Larsen |
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| Gender | Male |
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| Speciality | Surgery |
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| Location | 1315 Hospital Dr, St Johnsbury, Vermont |
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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: 1144340712
- Provider Enumeration Date: 03/29/2007
- Last Update Date: 02/13/2015
Medicare PECOS Information:
- PECOS PAC ID: 6608063169
- Enrollment ID: I20161222000338
Medical Identifiers
Medical identifiers for Dr Terry Lee Larsen such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1144340712 | NPI | - | NPPES |
| 1017931 | Medicaid | VT | |
| 3075442 | Medicaid | NH | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 208600000X | Surgery | 032.0066383 (Vermont) | 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 Terry Lee Larsen allows following entities to bill medicare on his behalf.
| Entity Name | Cottage Hospital |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1528162799
PECOS PAC ID: 1951219617
Enrollment ID: O20050509000013 |
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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 Terry Lee 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 |
|---|
Dr Terry Lee Larsen, DO
Po Box 905,
St Johnsbury, VT 05819-0905
Ph: (802) 748-8141 | Dr Terry Lee Larsen, DO
1315 Hospital Dr,
St Johnsbury, VT 05819-9210
Ph: (802) 748-8141 |
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