MADELINE JO LARSON (PA-C) – Physician Assistant, NPI 1366247173

MADELINE JO LARSON (PA-C) is a healthcare provider. based in Lafayette, Colorado. specializing in PHYSICIAN ASSISTANT. They hold the professional credentials PA-C. They hold a License No. PA.0009316 (CO). The NPI Number for MADELINE JO LARSON (PA-C) is 1366247173

Main info

Female
1 Year Of Experience
Accepts Medicare Assignment
Name
MADELINE JO LARSON (PA-C)
NPI
1366247173
Phone
(303) 604-1444
Address
1140 W SOUTH BOULDER RD STE 202
Enumeration Date
17 February 2025
Last Update Date
19 August 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
3036041444
Graduation Year
2025 (1 year ago)
PAC ID
2466954151
Group Practice PAC ID
9335037159
Professional Enrollment ID
I20250903002102
Address ID
CO803012319BO3000XDRXX401
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience31
Completeness85
Years active:1State licenses:1Digital endpointsOther names

4,161 PHYSICIAN ASSISTANT in CO

Provider Addresses for MADELINE JO LARSON (PA-C)

  • 1140 W SOUTH BOULDER RD STE 202

    LAFAYETTE, CO 800268910

    Phone: (303) 604-1444

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2025-09-03

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20250903002102IPhysician AssistantCOTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 80026)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 9335037159View full group profile
NameSpecialtyState
Physician AssistantCO
D E R M A T O L O G YCO
Physician AssistantCO
Physician AssistantGA
D E R M A T O L O G YCO
Physician AssistantCO
Physician AssistantCO
D E R M A T O L O G YCO

Reviews

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Frequently asked questions

Is MADELINE JO LARSON (PA-C) listed with a National Provider Identifier?
Yes — MADELINE JO LARSON (PA-C) has NPI 1366247173 on file in the registry.
Is MADELINE JO LARSON (PA-C) still an active registrant?
MADELINE JO LARSON (PA-C) carries an active NPI according to the public dataset.
What clinical focus is listed for MADELINE JO LARSON (PA-C)?
At a glance, MADELINE JO LARSON (PA-C) is tied to Physician Assistant. Clinical services aligned with this taxonomy classification.
What locale is associated with MADELINE JO LARSON (PA-C)?
Directory geography for MADELINE JO LARSON (PA-C) centers on Lafayette, Colorado.
Can I trust this NPI listing for MADELINE JO LARSON (PA-C)?
The listing is sourced from the national NPI registry. If something looks off, compare with NPPES and the clinic's website.

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