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MRS. LARISA ANN GILLERN PHYSICIAN ASSISTANT
NPI 1639793557
Physician Assistant - Surgical in Greenwich, CT

Active since June 05, 2020PECOS Enrolled
5 PERRYRIDGE RD, GREENWICH, CT 06830(203) 863-3000 Get Directions Write a Review

NPPES record last updated: October 14, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Mrs. Larisa Ann Gillern Physician Assistant NPPES

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

MRS. LARISA ANN GILLERN PHYSICIAN ASSISTANT (NPI 1639793557) is an individual surgical provider in Greenwich, Connecticut and active in the NPI registry since June 2020. She is enrolled in Medicare PECOS and is a graduate of Other (2021).

NPPES Registry Identity

NPI1639793557
Entity TypeIndividualFemale
Primary Taxonomy363AS0400X
Provider Legal NameMRS. LARISA ANN GILLERNCredential: PHYSICIAN ASSISTANT
Location Address5 PERRYRIDGE RDGreenwich, CT 06830-4608
Mailing Address74 Ocean AveMilford, CT 06460-5341 · (203) 979-4882
Phone(203) 863-3000
Sole ProprietorYes
Medical School CMSOtherGraduated 2021
Enumeration DateJune 5, 2020
Last NPPES UpdateOctober 14, 2025
NPPES CertifiedOctober 14, 2025
✔ NPI 1639793557 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician Assistant · SurgicalPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363AS0400X
5 PERRYRIDGE RD, Greenwich, CT 06830
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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)

Mrs. Larisa Ann Gillern Physician Assistant is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID6901384049
PECOS Enrollment IDI20260130002042
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.

Other Providers at the Same Location NPPES 20

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

ZARA NADIA ILAHI MD
Pediatrics (Neonatal-Perinatal Medicine)
5 PERRYRIDGE RD
GREENWICH, CT 06830
Western Connecticut Planning Region (203) 863-3000
SARAH STAMPER M.D.
Student in an Organized Health Care Education/Training Program
5 PERRYRIDGE RD, MEDICAL EDUCATION
GREENWICH, CT 06830
Western Connecticut Planning Region (203) 863-3409
JUNE EVELYN JEON MD
Student in an Organized Health Care Education/Training Program
5 PERRYRIDGE RD
GREENWICH, CT 06830
Western Connecticut Planning Region (203) 863-3000
ARIANA DOMINICUS PA-C
Physician Assistant
5 PERRYRIDGE RD
GREENWICH, CT 06830
Western Connecticut Planning Region (203) 863-3000
ERIC LI-MING HUANG BSC, PHARMD
Pharmacist (Pharmacotherapy)
5 PERRYRIDGE RD
GREENWICH, CT 06830
Western Connecticut Planning Region (203) 863-3199
ROSEMARY PERLEY-KWAUK CRNA
Nurse Anesthetist, Certified Registered
5 PERRYRIDGE RD
GREENWICH, CT 06830
Western Connecticut Planning Region (203) 661-5330
DR. FRANCISCO J BREA MD
Anesthesiology
5 PERRYRIDGE RD
GREENWICH, CT 06830
Western Connecticut Planning Region (203) 661-5330
ANNE YAN TING CHUA MBBS
Student in an Organized Health Care Education/Training Program
5 PERRYRIDGE RD
GREENWICH, CT 06830
Western Connecticut Planning Region (203) 863-3409

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 Larisa Gillern's NPI number?

The NPI number for Larisa Gillern is 1639793557. It was assigned to this individual provider in the NPPES registry on June 5, 2020.

Where is Larisa Gillern located?

Larisa Gillern practices at 5 Perryridge Rd, Greenwich, CT 06830. The listed phone number is (203) 863-3000.

What is Larisa Gillern's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Surgical, with taxonomy code 363AS0400X.

Is Larisa Gillern enrolled in Medicare?

Yes. Larisa Gillern is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Larisa Gillern was last updated on October 14, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 months 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.