John W Larsen, MD is a medicare enrolled "Otolaryngology - Otology & Neurotology" physician in Waconia, Minnesota. His current practice location is
490 S Maple St, Suite 205, Waconia, Minnesota. You can reach out to his office (for appointments etc.) via phone at
(952) 925-5626.
John W Larsen is licensed to practice in Minnesota (license number 20221) 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 1497863401.
Physician's Profile
| Full Name | John W Larsen |
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| Gender | Male |
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| Speciality | Otolaryngology - Otology & Neurotology |
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| Location | 490 S Maple St, Waconia, Minnesota |
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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: 1497863401
- Provider Enumeration Date: 08/29/2006
- Last Update Date: 05/12/2008
Medicare PECOS Information:
- PECOS PAC ID: 3577522192
- Enrollment ID: I20061204000363
Medical Identifiers
Medical identifiers for John W Larsen such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1497863401 | NPI | - | NPPES |
| 489395600 | Medicaid | MN | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 207YX0901X | Otolaryngology - Otology & Neurotology | 20221 (Minnesota) | 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. John W Larsen allows following entities to bill medicare on his behalf.
| Entity Name | Ridgeview Clinics |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1659389310
PECOS PAC ID: 4587559612
Enrollment ID: O20040218000363 |
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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. John W 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 |
|---|
John W Larsen, MD
490 S Maple St, Suite 205,
Waconia, MN 55387-1760
Ph: (952) 925-5626 | John W Larsen, MD
490 S Maple St, Suite 205,
Waconia, MN 55387-1760
Ph: (952) 925-5626 |
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