KEITH LARSON PA-C
NPI 1912027772
Physician Assistant - Surgical in Detroit, MI

Active since March 29, 2007PECOS Enrolled
3901 BEAUBIEN ST, DETROIT, MI 48201(313) 745-5437 Get Directions Write a Review

NPPES record last updated: July 8, 2007. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Keith Larson Pa-c NPPES

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

KEITH LARSON PA-C (NPI 1912027772) is an individual surgical provider in Detroit, Michigan, licensed in Michigan (5601002740) and active in the NPI registry since March 2007. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1912027772
Entity TypeIndividualMale
Primary Taxonomy363AS0400X
Provider Legal NameKEITH LARSONCredential: PA-C
Location Address3901 BEAUBIEN STDetroit, MI 48201-2119
Mailing Address3901 Beaubien Chm Dept Of Cardiovascular SurgeryDetroit, MI 48201 · (313) 745-5538
Sole ProprietorNo
Enumeration DateMarch 29, 2007
Last NPPES UpdateJuly 8, 2007
NPI 1912027772 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
License Licensed in MI · 5601002740
3901 BEAUBIEN ST, Detroit, MI 48201

Accepted Insurance

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

Enrolled in Medicare (PECOS)

Keith Larson Pa-c 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.

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.

Pediatrics (Pediatric Emergency Medicine)
3901 BEAUBIEN ST
DETROIT, MI 48201
Nurse Practitioner (Pediatrics)
3901 BEAUBIEN ST
DETROIT, MI 48201
Pediatrics
3901 BEAUBIEN ST
DETROIT, MI 48201
Physician Assistant (Surgical)
3901 BEAUBIEN ST
DETROIT, MI 48201
Pediatrics
3901 BEAUBIEN ST
DETROIT, MI 48201
Nurse Practitioner (Pediatrics)
3901 BEAUBIEN ST
DETROIT, MI 48201
Pharmacist
3901 BEAUBIEN ST
DETROIT, MI 48201
Pharmacist
3901 BEAUBIEN ST
DETROIT, MI 48201

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 Keith Larson's NPI number?

The NPI number for Keith Larson is 1912027772. It was assigned to this individual provider in the NPPES registry on March 29, 2007.

Where is Keith Larson located?

Keith Larson practices at 3901 Beaubien St, Detroit, MI 48201. The listed phone number is (313) 745-5437.

What is Keith Larson's specialty?

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

Is Keith Larson enrolled in Medicare?

Yes. Keith Larson is registered in the Medicare PECOS enrollment system.

What insurance does Keith Larson accept?

Health plans from Premera Blue Cross Blue Shield of Alaska and Providence Health Plan list Keith Larson as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Keith Larson was last updated on July 8, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 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.