DR. KATHLEEN M LARSON (M.D.) – Family Medicine Physician, NPI 1073598975

DR. KATHLEEN M LARSON (M.D.) is a healthcare provider. based in St louis park, Minnesota. specializing in FAMILY PRACTICE, DERMATOLOGY. They hold the professional credentials M.D.. They hold a License No. 46239 (MN). The NPI Number for DR. KATHLEEN M LARSON (M.D.) is 1073598975

Main info

Female
25 Years Of Experience
Accepts Medicare Assignment
Name
DR. KATHLEEN M LARSON (M.D.)
NPI
1073598975
Phone
Not provided
Address
6465 WAYZATA BLVD
Enumeration Date
13 December 2005
Last Update Date
5 October 2011

Doctor Profile

Medical School Name
UNIVERSITY OF MINNESOTA MEDICAL SCHOOL
Secondary Phone
9529934500
Graduation Year
2001 (25 years ago)
PAC ID
8022090737
Group Practice PAC ID
7911819438
Professional Enrollment ID
I20040607000024
Address ID
MN553055201MI15111DRXX500
Telehealth
Yes
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience54
Completeness75
Years active:20State licenses:1Digital endpointsOther names

3,076 FAMILY PRACTICE in MN

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Provider Addresses for DR. KATHLEEN M LARSON (M.D.)

  • Wayzata Boulevard, Blackstone, Saint Louis Park, Hennepin County, Minnesota, 55416, United States

    STE 315

    ST LOUIS PARK, MN 554261728

    Phone:

    Type: Mailing

  • 15111, Twelve Oaks Center Drive, Minnetonka, Hennepin County, Minnesota, 55305, United States

    MINNETONKA, MN 553055201

    Phone: (952) 993-4550

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2004-06-07

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20040607000024IFamily PracticeMNTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
36415Insertion of needle into vein for collection of blood sample17085$0
99214Established patient office or other outpatient visit, 30-39 minutes12694$0
G0439Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit7272$0
85025Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count2827$0
99215Established patient office or other outpatient visit, 40-54 minutes2523$0
View full utilization report →

Insurance plans in this area (ZIP 55426)

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Provider's Procedures

DR. KATHLEEN M LARSON (M.D.) performs procedures in FAMILY PRACTICE. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
FAMILY MEDICINEMN90670Pneumococcal vaccine for injection into muscle1212

Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 7911819438View full group profile
NameSpecialtyState
O B S T E T R I C S/ G Y N E C O L O G YMN
Family PracticeMN
-MN
Pulmonary Disease, Critical Care (Intensivists), Internal MedicineMN
Cardiac ElectrophysiologyMN
Family PracticeMN
Physician AssistantMN
Physical Therapist In Private PracticeMN
Physician AssistantMN
D E R M A T O L O G YMN

Reviews

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Frequently asked questions

What is the standard ID for DR. KATHLEEN M LARSON (M.D.) in the U.S.?
In the U.S., DR. KATHLEEN M LARSON (M.D.) is identified by NPI 1073598975.
Quick check: is DR. KATHLEEN M LARSON (M.D.) active?
Public NPPES data shows DR. KATHLEEN M LARSON (M.D.) with an active NPI status right now.
How should patients interpret DR. KATHLEEN M LARSON (M.D.)'s specialty?
The extract shows Family Medicine Physician for DR. KATHLEEN M LARSON (M.D.). Clinical services aligned with this taxonomy classification.
Which community is linked to DR. KATHLEEN M LARSON (M.D.)?
DR. KATHLEEN M LARSON (M.D.) shows a connection to St Louis Park, Minnesota in registry-derived data.
Who maintains DR. KATHLEEN M LARSON (M.D.)'s record?
Providers certify NPPES data; CMS hosts the public file you are viewing.

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