Steven A Larsen (NPI# 1508953555, PAC ID# 7517965064) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is DIAGNOSTIC RADIOLOGY.
| Nation Provider ID (NPI) | 1508953555 |
| PAC ID by PECOS | 7517965064 |
| Professional Enrollment ID | I20080219000846 |
| Full Name | Steven A Larsen |
| Organization Legal Name | TETON RADIOLOGY MADISON LLC |
| Address |
425 E 4th Rexburg ID 83440-5390 |
| Phone Number | 2083564888 |
| Gender | M |
| Credential | MD |
| Medical School | UNIVERSITY OF UTAH SCHOOL OF MEDICINE |
| Graduation Year | 2001 |
| Primary Specialty | DIAGNOSTIC RADIOLOGY |
| Group Practice PAC ID | 6901958024 |
| Number of Group Practice Members | 26 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 130028 | PORTNEUF MEDICAL CENTER |
| 131325 | BINGHAM MEMORIAL HOSPITAL |
| 271314 | DEER LODGE MEDICAL CENTER - CAH |
| 131309 | CARIBOU MEMORIAL HOSPITAL |
| 131322 | FRANKLIN COUNTY MEDICAL CENTER |
| Address | Phone | Organization |
|---|---|---|
| 901 Adams St, Afton, WY 83110-9621 | 3078855877 | MEDICAL IMAGING ASSOC OF IDAHO FALLS PA |
| 3100 Channing Way, Idaho Falls, ID 83404-7533 | 2085296111 | MEDICAL IMAGING ASSOC OF IDAHO FALLS PA |
| 777 Hospital Way, Pocatello, ID 83201-5175 | 2082391000 | MEDICAL IMAGING ASSOC OF IDAHO FALLS PA |
| 425 E 4th, Rexburg, ID 83440-5390 | 2083564888 | TETON RADIOLOGY MADISON LLC |
| 1208 6th Ave, Superior, MT 59872-9618 | 4068224841 | MEDICAL IMAGING ASSOC OF IDAHO FALLS PA |
| Measure Identifier | Measure Title | Performance Rate | Reporting Mechanism |
|---|---|---|---|
| MIPS_EC_359_overall | Optimizing Patient Exposure to Ionizing Radiation: Utilization of a Standardized Nomenclature for Computed Tomography (CT) Imaging Description | 100% | |
| MIPS_EC_359_overall | Optimizing Patient Exposure to Ionizing Radiation: Utilization of a Standardized Nomenclature for Computed Tomography (CT) Imaging Description | 100% | |
| MIPS_EC_359_overall | Optimizing Patient Exposure to Ionizing Radiation: Utilization of a Standardized Nomenclature for Computed Tomography (CT) Imaging Description | 100% | |
| MIPS_EC_361_overall | Optimizing Patient Exposure to Ionizing Radiation: Reporting to a Radiation Dose Index Registry | 100% | |
| MIPS_EC_361_overall | Optimizing Patient Exposure to Ionizing Radiation: Reporting to a Radiation Dose Index Registry | 100% | |
| MIPS_EC_361_overall | Optimizing Patient Exposure to Ionizing Radiation: Reporting to a Radiation Dose Index Registry | 100% |
| Organization Legal Name | TETON RADIOLOGY MADISON LLC |
| Physicians | 1 |
| Street Address |
425 E 4TH |
| City | REXBURG |
| State | ID |
| Zip | 83440-5390 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Craig Benjamin Ashby | Chiropractic | 16 S 1st, Rexburg, ID 83440-0303 | |
| Adriann J Wilcox | Nurse Practitioner | Madison Co Memorial Hospital | 393 E 2nd, Rexburg, ID 83440-1605 |
| Corey T Rammell | Family Medicine | Madison Co Memorial Hospital | 393 E 2nd, Rexburg, ID 83440-1605 |
| Joseph E Watson | Family Medicine | Madison Co Memorial Hospital | 393 E 2nd, Rexburg, ID 83440-1605 |
| Matheau G Eysser | Orthopedic Surgery | Madison Co Memorial Hospital | 393 E 2nd, Rexburg, ID 83440-1605 |
| Zachery M Brunson | Physician Assistant | Madison Co Memorial Hospital | 393 E 2nd, Rexburg, ID 83440-1605 |
| Charles J Zollinger | Family Medicine | Madison Co Memorial Hospital | 393 E 2nd, Rexburg, ID 83440-1605 |
| Rex Meredith | Physician Assistant | Madison Co Memorial Hospital | 393 E 2nd, Rexburg, ID 83440-1605 |
| Wade D Gordon | Clinical Social Worker | 310 N 2nd E, 112 South Fork Services, Rexburg, ID 83440-1606 | |
| Jody B Rawlings | Physical Therapy | 217 N 2nd, Rexburg, ID 83440-1621 | |
| Find all physicians in zip 83440 | |||
| City | REXBURG |
| Zip Code | 83440 |
| Specialty | DIAGNOSTIC RADIOLOGY |
| City + Specialty | REXBURG + DIAGNOSTIC RADIOLOGY |
Please comment or provide details below to improve the information on Steven A Larsen.
| 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.