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DR. KIMBERLY DESTEFANO LARSEN MD
NPI 1265480347
Family Medicine in Prince Frederick, MD

Active since May 04, 2006PECOS Enrolled
110 HOSPITAL DR, SUITE 111, PRINCE FREDERICK, MD 20678(410) 535-4488(410) 535-6131 Get Directions Write a Review

NPPES record last updated: May 21, 2018. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Dr. Kimberly Destefano Larsen Md NPPES

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

DR. KIMBERLY DESTEFANO LARSEN MD (NPI 1265480347) is an individual family medicine provider in Prince Frederick, Maryland, licensed in Maryland (D51722) and active in the NPI registry since May 2006. She is enrolled in Medicare PECOS and maintains a secondary practice location in Prince Frederick.

NPPES Registry Identity

NPI1265480347
Entity TypeIndividualFemale
Primary Taxonomy207Q00000X
Provider Legal NameDR. KIMBERLY DESTEFANO LARSENCredential: MD
Location Address110 HOSPITAL DR, SUITE 111Prince Frederick, MD 20678
Mailing Address9910 Franklin Square Dr Ste 2110Baltimore, MD 21236-4902 · (410) 933-5412 · Fax (410) 535-6131
Phone(410) 535-4488
Fax(410) 535-6131
Sole ProprietorNo
Enumeration DateMay 4, 2006
Last NPPES UpdateMay 21, 2018
✔ NPI 1265480347 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in MD · D51722
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
110 HOSPITAL DR, Prince Frederick, MD 20678
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Secondary Practice Location 1

Location 1110 Hospital Dr, Suite 111Prince Frederick, MD 20678 · Phone (410) 535-4488 · Fax (410) 535-6131

Other Identifiers 2

Other5619003Bcbs Federal
Medicaid123200560MD

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Kimberly Destefano Larsen Md 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 20678 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
$89.75 typical visit price
range $57.99 – $175.57
Typical copayment $22.43 (range $14.49 – $43.89)
Most-billed visit code 99203
Established Patient
$102.11 typical visit price
range $18.66 – $143.02
Typical copayment $25.52 (range $4.66 – $35.75)
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.

Referred Medical Equipment & Supplies CMS DME claims

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing A6219
DME-Medical/Surgical Supplies · category DA023N
1 supplier11 claims195 services$0.92 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES

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

JOHN MICHAEL BROOKS MD
Family Medicine
110 HOSPITAL DR, SUITE 111
PRINCE FREDERICK, MD 20678
Calvert County (410) 535-4488

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 Kimberly Larsen's NPI number?

The NPI number for Kimberly Larsen is 1265480347. It was assigned to this individual provider in the NPPES registry on May 4, 2006.

Where is Kimberly Larsen located?

Kimberly Larsen practices at 110 Hospital Dr Suite 111, Prince Frederick, MD 20678. The listed phone number is (410) 535-4488.

What is Kimberly Larsen's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Kimberly Larsen enrolled in Medicare?

Yes. Kimberly Larsen is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Kimberly Larsen was last updated on May 21, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 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.