Larissa Kaneesha Peterson, in Los Angeles, CA

Larissa Kaneesha Peterson, is a medicare enrolled "Nurse Practitioner - Family" in Los Angeles, California. Her current practice location is 1180 S Beverly Dr Ste 700, Los Angeles, California. You can reach out to her office (for appointments etc.) via phone at (424) 334-6288.

Larissa Kaneesha Peterson is licensed to practice in California (license number 95014921) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1225506397.

Contact Information

	Larissa Kaneesha Peterson,
	1180 S Beverly Dr Ste 700, Los Angeles, CA 90035-1151
	(424) 334-6288
	Not Available

Map and Direction

Provider's Profile

Full Name	Larissa Kaneesha Peterson
Gender	Female
Speciality	Nurse Practitioner - Family
Location	1180 S Beverly Dr Ste 700, Los Angeles, California
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1225506397
Provider Enumeration Date: 11/07/2018
Last Update Date: 05/08/2024

Medicare PECOS Information:

PECOS PAC ID: 9133466592
Enrollment ID: I20190123004265

Medical Identifiers

Medical identifiers for Larissa Kaneesha Peterson such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1225506397	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363LF0000X	Nurse Practitioner - Family	0024176854 (Virginia)	Secondary
363LF0000X	Nurse Practitioner - Family	95014921 (California)	Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Larissa Kaneesha Peterson allows following entities to bill medicare on her behalf.

Entity Name	Emergency Medicine Associates Pa Pc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1134117393 PECOS PAC ID: 8022914522 Enrollment ID: O20031208000283

Entity Name	Stafford Urgent Care Inc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1477582773 PECOS PAC ID: 3072585645 Enrollment ID: O20040812001000

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Larissa Kaneesha Peterson is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Larissa Kaneesha Peterson, 1 California St Ste 2300, San Francisco, CA 94111-5424 Ph: () -	Larissa Kaneesha Peterson, 1180 S Beverly Dr Ste 700, Los Angeles, CA 90035-1151 Ph: (424) 334-6288

Reviews and Comments

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Larissa Kaneesha Peterson, - Medicare Nurse Practitioner in Los Angeles, CA