DR. MATTHEW JAMES LARSON (NPI# 1154386423) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1154386423 |
Entity Type | Individual |
Full Name | DR. MATTHEW JAMES LARSON |
Credential | M.D. |
Practice Address |
1215 Town Centre Dr Suite 200 Eagan MN 55123-1033 |
Mailing Address |
60 Plato Blvd E Suite 270 Saint Paul MN 55107-1827 |
Practice Telephone | 6512513300 |
Practice Fax Number | 6512553450 |
Mailing Telephone | 6512091600 |
Mailing Fax Number | 6512919169 |
Enumeration Date | 2006-04-19 |
Last Update Date | 2013-10-02 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 207N00000X | Dermatology | 46578 | MN | Allopathic & Osteopathic Physicians |
State | Issuer | Identifier | Type Code |
---|---|---|---|
MN | MEDICARE PTAN | 070001049 | 01 |
MN | RAILROAD MEDICARE | P01199766 | 01 |
MN | MEDICA | 0030001093 | 01 |
MN | BLUE SHIELD | 0FE27LA | 01 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1043534878 | Matthew Golden Larson | Chiropractor | 9316 Carnation Duvall Rd Ne, Carnation, WA 98014-6706 | 2010-03-23 |
1417113648 | Matthew J Larson | Driver | 2112 Hoffman Rd, Mankato, MN 56001-5829 | 2008-08-07 |
1326002437 | Matthew G. Larson | Social Worker | 24 S 600 E, Ste. 6, Slc, UT 84102 | 2006-04-14 |
1346703634 | Matthew Daniel Larson | Student in an Organized Health Care Education/Training Program | 3901 Rainbow Blvd, Kansas City, KS 66160-8500 | 2019-04-12 |
1205315108 | Matthew Larson | Physical Therapist | 433 Mendota Rd E, West St Paul, MN 55118-5104 | 2018-08-10 |
1316444615 | Matthew Erick Larson | Radiology | 600 Highland Ave, Madison, WI 53792-0001 | 2018-04-12 |
1316352834 | Matthew Larson | Optometrist | 3450 Lacey Rd, Downers Grove, IL 60515-5430 | 2014-06-23 |
1982941027 | Matthew Larson | Social Worker | 16 12th Ave S, Suite 201, Nampa, ID 83651-3936 | 2013-01-09 |
1922353739 | Matthew W Larson | Pharmacist | 23 Slayton Ave, Spencerport, NY 14559-1427 | 2012-07-17 |
1609134675 | Matthew Thor Larson | Pharmacist | 20 W Main St, Crosby, MN 56441-1422 | 2012-04-27 |
Street Address |
1215 TOWN CENTRE DR SUITE 200 |
City | EAGAN |
State | MN |
Zip Code | 55123-1033 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1063489540 | Charles E Pogemiller Sr. | Family Medicine | 1215 Town Centre Dr, Eagan, MN 55123-1033 | 2006-03-03 |
1215227590 | Jozef Lazar | Dermatology | 1215 Town Centre Dr, Suite 200, Eagan, MN 55123-1033 | 2011-04-07 |
1912167487 | Kathryn Colleen Barlow | Dermatology | 1215 Town Centre Dr, Suite 200, Eagan, MN 55123-1033 | 2008-06-09 |
1013195791 | Sheila Rae Rodstein | Family Medicine | 1215 Town Centre Dr, Eagan, MN 55123-1033 | 2008-02-05 |
1730298910 | Kristina Kelly Shaffer | Dermatology | 1215 Town Centre Dr, Suite 200, Eagan, MN 55123-1033 | 2006-08-30 |
1427167691 | Joseph Jacob Shaffer | Dermatology | 1215 Town Centre Dr, Suite 200, Eagan, MN 55123-1033 | 2006-08-30 |
1306955802 | Noel Anthony Hauge | Dermatology | 1215 Town Centre Dr, Suite 200, Eagan, MN 55123-1033 | 2006-08-29 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1053828467 | Hilltop Family Chiropractic Center Pa | Chiropractor | 1121 Town Centre Drive Suite 202, Eagan, MN 55123 | 2018-01-08 |
1922452507 | Jacob Zimmerman | Counselor | 3450 O'leary Ln., Eagan, MN 55123 | 2016-04-20 |
1316320971 | K-squared Fitness, L.L.C. | Public Health or Welfare | 1100 Cliff Rd, Eagan, MN 55123 | 2015-07-01 |
1346683687 | Joshua M Dorn | Allergy & Immunology | 3460 Promenade Ave, Eagan, MN 55123 | 2013-04-16 |
1700172350 | Mary Christine Mcnabney | Nurse Practitioner | 610 Opperman Drive, D4 Health Center, Your Wellbeing Health Center, Eagan, MN 55123 | 2011-06-22 |
1033353669 | Todd Borstad | Social Worker | 3450 O'leary Lane, Eagan, MN 55123 | 2009-04-27 |
1821025271 | Mngi Endoscopy LLC | Clinic/Center | 1185 Town Centre Drive, Eagan, MN 55123 | 2006-06-28 |
1780620120 | Cindy Eileen Wood | Audiologist | 3440 Oleary Lane, 240, Eagan, MN 55123 | 2006-06-22 |
1609845742 | Jeffery R Dichter | Internal Medicine | 849 Govern Circle, Saint Paul, MN 55123 | 2006-03-14 |
1891269155 | Elise Broderick Quam | Social Worker | 3450 Oleary Ln, Eagan, MN 55123 | 2019-01-18 |
Find all providers in zip 55123 |
Taxonomy Code | 207N00000X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Dermatology |
A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging. |
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source] Additional Resources: American Board of Dermatology, 2007. http://www.abderm.org/ Board certification is provided by the American Board of Dermatology. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1215227590 | Jozef Lazar | Dermatology | 1215 Town Centre Dr, Suite 200, Eagan, MN 55123-1033 | 2011-04-07 |
1912167487 | Kathryn Colleen Barlow | Dermatology | 1215 Town Centre Dr, Suite 200, Eagan, MN 55123-1033 | 2008-06-09 |
1730298910 | Kristina Kelly Shaffer | Dermatology | 1215 Town Centre Dr, Suite 200, Eagan, MN 55123-1033 | 2006-08-30 |
1427167691 | Joseph Jacob Shaffer | Dermatology | 1215 Town Centre Dr, Suite 200, Eagan, MN 55123-1033 | 2006-08-30 |
1306955802 | Noel Anthony Hauge | Dermatology | 1215 Town Centre Dr, Suite 200, Eagan, MN 55123-1033 | 2006-08-29 |
1962426502 | Crutchfield Dermatology, P.a. | Dermatology | 1185 Town Centre Dr, Suite 101, Eagan, MN 55123-1187 | 2006-07-27 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1962871608 | Lakes Dermatology, Pa | Dermatology | 14305 Southcross Dr W, Suite 110, Burnsville, MN 55306-7009 | 2015-09-23 |
1194133157 | Adam Schmitt | Dermatology | 2 Carlson Pkwy N Ste 240, Plymouth, MN 55447 | 2014-07-22 |
1578982773 | Lori Ann Fiessinger | Dermatology | 420 Delaware Street Se, Mmc 98, Minneapolis, MN 55455 | 2014-04-15 |
1942629795 | Shane O'neil | Dermatology | 500 Osborne Rd Ne Ste 330, Fridley, MN 55432 | 2014-04-09 |
1033537782 | Erin Sellinger | Dermatology | 2 Carlson Pkwy N, Ste 240, Plymouth, MN 55447-4485 | 2014-03-31 |
1033555230 | Samuel Blake Ecker | Dermatology | 3655 Plymouth Blvd Ste 110, Minneapolis, MN 55446-3665 | 2013-05-14 |
1295078913 | Jessica Jane Newman | Dermatology | 4-240, Phillips-wangensteen Bldg., 516 Delaware Street S.e., Mail Code 98, Minneapolis, MN 55455 | 2013-04-01 |
1437416088 | Tiffany Lynn Shih | Dermatology | 401 Phalen Blvd # Ms 41102b, Saint Paul, MN 55130-5302 | 2012-04-20 |
1124317383 | Sara Anne Hylwa | Dermatology | 730 South 8th Street, Department of Dermatology, Minneapolis, MN 55415 | 2011-03-28 |
1770885360 | Thomas Joseph Kalb | Dermatology | 13420 106th St., Young America, MN 55397-5401 | 2010-12-02 |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.