Latasha Larson, OT is a medicare enrolled "Occupational Therapist - Environmental Modification" provider in Corcoran, Minnesota. Her current practice location is
19120 Mystique Dr, Corcoran, Minnesota. You can reach out to her office (for appointments etc.) via phone at
(320) 293-3205.
Latasha Larson is licensed to practice in Minnesota (license number 103693) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1346911351.
Healthcare Provider's Profile
| Full Name | Latasha Larson |
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| Gender | Female |
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| Speciality | Occupational Therapist - Environmental Modification |
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| Location | 19120 Mystique Dr, Corcoran, Minnesota |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1346911351
- Provider Enumeration Date: 09/21/2021
- Last Update Date: 01/17/2023
Medicare PECOS Information:
- PECOS PAC ID: 8426456377
- Enrollment ID: I20211007002208
Medical Identifiers
Medical identifiers for Latasha Larson such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
| 1346911351 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
| 225X00000X | Occupational Therapist | 103693 (Minnesota) | Secondary |
| 225XG0600X | Occupational Therapist - Gerontology | 103693 (Minnesota) | Secondary |
| 225XE0001X | Occupational Therapist - Environmental Modification | 103693 (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. Latasha Larson allows following entities to bill medicare on her behalf.
| Provider Name | Fox Rehabilitation Services Mn Llc |
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| Provider Type | Part B Supplier - Physical/occupational Therapy Group In Private Practice |
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| Provider Identifiers | NPI Number: 1356802862 PECOS PAC ID: 0941542591 Enrollment ID: O20190430002455 |
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| Provider Name | Adaptify Home Safety Solutions Llc |
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| Provider Type | Part B Supplier - Physical/occupational Therapy Group In Private Practice |
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| Provider Identifiers | NPI Number: 1881319093 PECOS PAC ID: 4183096274 Enrollment ID: O20230220000847 |
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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. Latasha Larson 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 |
Latasha Larson, OT 19120 Mystique Dr, Corcoran, MN 55340-9586 Ph: (320) 293-3205 | Latasha Larson, OT 19120 Mystique Dr, Corcoran, MN 55340-9586 Ph: (320) 293-3205 |
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