| Tom D Larson, MD | |
|
7595 Anagram Dr, Eden Prairie, MN 55344-7399 | |
| (612) 573-2200 | |
| (612) 573-2250 |
| Full Name | Tom D Larson |
|---|---|
| Gender | Male |
| Speciality | Diagnostic Radiology |
| Experience | 37 Years |
| Location | 7595 Anagram Dr, Eden Prairie, Minnesota |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1598793226 | NPI | - | NPPES |
| 16-04032 | Other | MN | LARSON MEDICA # |
| HP25797 | Other | MN | LARSON HEALTHPARTNERS # |
| 1015556 | Other | MN | LARSON PREFERRED ONE # |
| 163020200 | Medicaid | MN | |
| 03N49LA | Other | MN | LARSON BCBS # |
| 18046 | Medicaid | ND |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2085R0202X | Radiology - Diagnostic Radiology | 43983 (Minnesota) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Firstlight Health System | Mora, MN | Hospital |
| Cambridge Medical Center | Cambridge, MN | Hospital |
| Riverview Hospital | Crookston, MN | Hospital |
| Chi St Alexius Health Williston | Williston, ND | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Prairie Lakes Health Care System Inc | 8628987823 | 125 |
| Allina Health System | 4587573613 | 3861 |
| Consulting Radiologists Ltd | 7719899962 | 76 |
| Entity Name | Prairie Lakes Health Care System Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1720166002 PECOS PAC ID: 8628987823 Enrollment ID: O20040202000187 |
| Mailing Address | Practice Location Address |
|---|---|
| Tom D Larson, MD 7595 Anagram Dr, Eden Prairie, MN 55344-7399 Ph: (612) 573-2200 | Tom D Larson, MD 7595 Anagram Dr, Eden Prairie, MN 55344-7399 Ph: (612) 573-2200 |
Norna L. Karp, M.D. Radiology Medicare: Medicare Enrolled Practice Location: 11995 Singletree Ln Ste 500, Eden Prairie, MN 55344 Phone: 952-595-1301 Fax: 612-294-4903 | |
Dr. Jiewen Li, DO Radiology Medicare: Accepting Medicare Assignments Practice Location: 7595 Anagram Dr, Eden Prairie, MN 55344 Phone: 612-573-2200 Fax: 612-573-2274 | |
Jacob Gebrael, MD Radiology Medicare: May Accept Medicare Assignments Practice Location: 11995 Singletree Ln Ste 500, Eden Prairie, MN 55344 Phone: 952-595-1301 Fax: 612-294-4903 | |
Dr. Trudy J Moore, MD Radiology Medicare: Medicare Enrolled Practice Location: 11995 Singletree Ln Ste 500, Eden Prairie, MN 55344 Phone: 952-595-1301 Fax: 612-294-4903 | |
Dr. Priti Bachubhai Ram, MD Radiology Medicare: Accepting Medicare Assignments Practice Location: 11995 Singletree Ln Ste 500, Eden Prairie, MN 55344 Phone: 952-595-1301 Fax: 612-294-4903 | |
Nathan J Groebner, M.D. Radiology Medicare: Accepting Medicare Assignments Practice Location: 7595 Anagram Dr, Eden Prairie, MN 55344 Phone: 612-573-2200 Fax: 612-573-2274 | |
Dr. Christopher James Macdonald, MD, PHD Radiology Medicare: Accepting Medicare Assignments Practice Location: 11995 Singletree Ln Ste 500, Eden Prairie, MN 55344 Phone: 952-595-1301 Fax: 612-294-4903 |