Derek S Larson (NPI# 1588820096, PAC ID# 7012194707) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is INTERNAL MEDICINE.
| Nation Provider ID (NPI) | 1588820096 |
| PAC ID by PECOS | 7012194707 |
| Professional Enrollment ID | I20140804002321 |
| Full Name | Derek S Larson |
| Organization Legal Name | ST LOUIS KIDNEY LLC |
| Address |
12855 N 40 Dr Suite 205 Saint Louis MO 63141-8670 |
| Phone Number | 3147200900 |
| Gender | M |
| Graduation Year | 2008 |
| Primary Specialty | INTERNAL MEDICINE |
| Secondary Specialties | NEPHROLOGY |
| Group Practice PAC ID | 0143446617 |
| Number of Group Practice Members | 6 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 260108 | MISSOURI BAPTIST MEDICAL CENTER |
| 260020 | MERCY HOSPITAL ST LOUIS |
| 261330 | STE GENEVIEVE COUNTY MEMORIAL HOSPITAL |
| 260023 | MERCY HOSPITAL JEFFERSON |
| 261315 | PARKLAND HEALTH CENTER-BONNE TERRE |
| Address | Phone | Organization |
|---|---|---|
| 12855 N 40 Dr, Suite 205, Saint Louis, MO 63141-8670 | 3147200900 | ST LOUIS KIDNEY LLC |
| 800 Genevieve Dr, Ste Genevieve, MO 63670-1434 | 3147200900 | ST LOUIS KIDNEY LLC |
| Measure Identifier | Measure Title | Performance Rate | Reporting Mechanism |
|---|---|---|---|
| ACI_EC_TRANS_EP_1 | e-Prescribing | 65% | |
| ACI_EC_TRANS_MR_1 | Medication Reconciliation | 99% | |
| ACI_EC_TRANS_PEA_1 | Provide Patient Access | 93% | |
| ACI_EC_TRANS_PEA_2 | View, Download, or Transmit (VDT) | 8% | |
| ACI_EC_TRANS_PHCDRR_1 | Immunization Registry Reporting | % | |
| ACI_EC_TRANS_PPHI_1 | Security Risk Analysis | % | |
| ACI_EC_TRANS_PSE_1 | Patient-Specific Education | 83% | |
| ACI_EC_TRANS_SM_1 | Secure Messaging | 6% | |
| MIPS_EC_047_overall | Care Plan | 34% |
| Organization Legal Name | ST LOUIS KIDNEY LLC |
| Physicians | 7 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Jay R Seltzer | Nephrology | St Louis Kidney LLC | 12855 N 40 Dr, Suite 205, Saint Louis, MO 63141-8670 |
| Rose L Mattli | Nurse Practitioner | St Louis Kidney LLC | 800 Genevieve Dr, Ste Genevieve, MO 63670-1434 |
| Candace R Shirley | Nurse Practitioner | St Louis Kidney LLC | 12855 N 40 Dr, Suite 205, Saint Louis, MO 63141-8670 |
| Brittany A Heady | Physician Assistant | St Louis Kidney LLC | 12855 N 40 Dr, Suite 205, Saint Louis, MO 63141-8670 |
| Graeme Mindel | Nephrology | St Louis Kidney LLC | 12855 N 40 Dr, Suite 205, Saint Louis, MO 63141-8670 |
| Veronica F Mcdonnell | Registered Dietitian Or Nutrition Professional | St Louis Kidney LLC | 12855 N 40 Dr, Saint Louis, MO 63141-8670 |
| Street Address |
12855 N 40 DR SUITE 205 |
| City | SAINT LOUIS |
| State | MO |
| Zip | 63141-8670 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Rachel Porter | Nurse Practitioner | Urology of St. Louis, Inc | 12855 N 40 Dr, Suite 375, Saint Louis, MO 63141-8657 |
| Danielle N Fries | Nurse Practitioner | Urology of St. Louis, Inc | 12855 N 40 Dr, Suite 375, Saint Louis, MO 63141-8657 |
| Jaeyoung Yoon | Dermatology | Forefront Dermatology Sc | 12855 N 40 Dr, Suite 180, Saint Louis, MO 63141-8657 |
| Sarah Alison Finger Basak | Dermatology | Forefront Dermatology Sc | 12855 N 40 Dr, Suite 180, Saint Louis, MO 63141-8657 |
| Karuna P Murray | Gynecological Oncology | 12855 N 40 Dr, Suite 325, Saint Louis, MO 63141-8668 | |
| Seth Strope | Urology | Urology of St. Louis, Inc | 12855 N 40 Dr, Suite 375, Saint Louis, MO 63141-8657 |
| Steven R Frank | Podiatry | Steven Frank, Dpm, LLC | 12855 N 40 Dr, Suite 175, Saint Louis, MO 63141-8664 |
| Demetrios A Katsikas | Urology | Urology of St. Louis, Inc | 12855 N 40 Dr, Suite 375, Saint Louis, MO 63141-8657 |
| Ryan W Couchman | Orthopedic Surgery | Mercy Clinic Surgical Specialists LLC | 12855 N 40 Dr, Suite 125, Saint Louis, MO 63141-8663 |
| Byron D Baptist | Internal Medicine | Mercy Clinic East Communities | 12855 N 40 Dr, 280 Mercy Clinic Diabetes and Nutrition Center, Saint Louis, MO 63141-8657 |
| Find all physicians in the same address | |||
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Lauren M Finnerty | Nurse Practitioner | Associated Physicians Group Ltd | 845 N New Ballas Court, Suite 120, Creve Couer, MO 63141 |
| Enos Moss | Nurse Practitioner | Mercy Clinic Adult Psychiatry LLC | 12125 Conway, Suite 160, St. Louis, MO 63141 |
| Matthew Stewart Wilson | Psychiatry | Mercy Clinic Adult Psychiatry LLC | 12125 Conway, Suite 160, St. Louis, MO 63141 |
| Erica Chick | Clinical Social Worker | Mercy Clinic Adult Psychiatry LLC | 12125 Conway, Suite 160, St. Louis, MO 63141 |
| Thomas Horn | Psychiatry | Mercy Clinic Adult Psychiatry LLC | 12125 Conway, Suite 160, St. Louis, MO 63141 |
| Tianyuan Yin Cornell | Psychiatry | Mercy Clinic Adult Psychiatry LLC | 12125 Conway, Suite 160, St. Louis, MO 63141 |
| Patricia L Tracy | Physical Therapy | Associated Physicians Group, Ltd | 845 N New Ballas Court, Creve Couer, MO 63141 |
| Kevin O Easley | Gynecological Oncology | Mercy Clinic Gyn Oncology LLC | 607 S New Ballas Rd, Suite 2350, Saint Louis, MO 63141-0001 |
| Kelly L Ball | Nurse Practitioner | Mercy Clinic Gyn Oncology LLC | 607 S New Ballas Rd, Suite 2350, Saint Louis, MO 63141-0001 |
| Amy Kelly Neu | Clinical Social Worker | Fitzgibbons Psychological West County Psychological Associates | 12125 Woodcrest Exec Dr, Suite 110, St Louis, MO 63141-5009 |
| Find all physicians in zip 63141 | |||
| City | SAINT LOUIS |
| Zip Code | 63141 |
| Specialty | INTERNAL MEDICINE |
| City + Specialty | SAINT LOUIS + INTERNAL MEDICINE |
Please comment or provide details below to improve the information on Derek S Larson.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.