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LARISSA KANEESHA PETERSON
NPI 1225506397
Nurse Practitioner - Family in Los Angeles, CA

Active since November 07, 2018PECOS Enrolled
1180 S BEVERLY DR STE 700, LOS ANGELES, CA 90035(424) 334-6288 Get Directions Write a Review

NPPES record last updated: May 8, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: May 8, 2024, Apr 23, 2024, Jan 10, 2023 and 1 more (4 updates tracked since 2018).

About Larissa Kaneesha Peterson NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

LARISSA KANEESHA PETERSON (NPI 1225506397) is an individual family provider in Los Angeles, California, licensed in California (95014921) and active in the NPI registry since November 2018. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1225506397
Entity TypeIndividualFemale
Primary Taxonomy363LF0000X
Provider Legal NameLARISSA KANEESHA PETERSON
Location Address1180 S BEVERLY DR STE 700Los Angeles, CA 90035-1151
Mailing Address1 California St Ste 2300San Francisco, CA 94111-5424
Phone(424) 334-6288
Sole ProprietorNo
Enumeration DateNovember 7, 2018
Last NPPES UpdateMay 8, 20244 updates tracked since enumeration
NPPES CertifiedMay 8, 2024
✔ NPI 1225506397 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
Licenses✔ Licensed in CA · 95014921✔ Licensed in VA · 0024176854
1180 S BEVERLY DR STE 700, Los Angeles, CA 90035
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Larissa Kaneesha Peterson is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 90035 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$96.36 typical visit price
range $62.96 – $187.60
Typical copayment $24.09 (range $15.74 – $46.90)
Most-billed visit code 99203
Established Patient
$109.96 typical visit price
range $20.84 – $153.61
Typical copayment $27.49 (range $5.21 – $38.40)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 4

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

NATALIE SAMIMI NP
Nurse Practitioner
1180 S BEVERLY DR STE 700
LOS ANGELES, CA 90035
Los Angeles County (213) 584-2331
MS. GRISELDA ROSAS NP
Nurse Practitioner (Family)
1180 S BEVERLY DR STE 700
LOS ANGELES, CA 90035
Los Angeles County (805) 890-8002
MEDIGENCE HEALTH PC
Nurse Practitioner
1180 S BEVERLY DR STE 700
LOS ANGELES, CA 90035
Los Angeles County (082) 526-7592
MRS. RANDI ALEXIS HICKMAN MSN FNP-C
Nurse Practitioner (Family)
1180 S BEVERLY DR STE 700
LOS ANGELES, CA 90035
Los Angeles County (571) 585-0576

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Larissa Peterson's NPI number?

The NPI number for Larissa Peterson is 1225506397. It was assigned to this individual provider in the NPPES registry on November 7, 2018.

Where is Larissa Peterson located?

Larissa Peterson practices at 1180 S Beverly Dr Ste 700, Los Angeles, CA 90035. The listed phone number is (424) 334-6288.

What is Larissa Peterson's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Is Larissa Peterson enrolled in Medicare?

Yes. Larissa Peterson is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Larissa Peterson was last updated on May 8, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.