MR. ANDREW JON LARSON (D.O.) – Dermatopathology (Pathology) Physician, NPI 1528296043
Dermatopathology (Pathology) Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for MR. ANDREW JON LARSON (D.O.)
13th Avenue North, Plymouth, Hennepin County, Minnesota, 55441, United States
SUITE 2A
PLYMOUTH, MN 554415035
Phone: (763) 525-0363
Fax: (763) 525-0369
Mailing address matches the actual address.
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.
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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: 2009-08-19
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
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20090819000728 | I | Pathology | MN | TBD |
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.
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
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 88305 | Pathology examination of tissue using a microscope, intermediate complexity | 106 | 89 | $0 |
Insurance plans in this area (ZIP 55441)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Micrographic Dermatologic Surgery (Mds) | PA | |
| D E R M A T O L O G Y | MN | |
| D E R M A T O L O G Y | MN | |
| D E R M A T O L O G Y | MN | |
| D E R M A T O L O G Y | MN | |
| P A T H O L O G Y | MN | |
| - | MN | |
| D E R M A T O L O G Y | MN | |
| D E R M A T O L O G Y | MN | |
| D E R M A T O L O G Y | MN |
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