LARS SPENCER NELSON (MD) – Surgery Physician, NPI 1780813592

LARS SPENCER NELSON (MD) is a healthcare provider. based in Jacksonville, Florida. specializing in GENERAL SURGERY. They hold the professional credentials MD. They hold a License No. ME123398 (FL). The NPI Number for LARS SPENCER NELSON (MD) is 1780813592

Main info

Male
17 Years Of Experience
Accepts Medicare Assignment
Name
LARS SPENCER NELSON (MD)
NPI
1780813592
Phone
(904) 396-1725
Address
11945 SAN JOSE BLVD
Enumeration Date
14 July 2009
Last Update Date
10 January 2017

Doctor Profile

Medical School Name
OTHER
Secondary Phone
3864254000
Graduation Year
2009 (17 years ago)
PAC ID
7012153240
Group Practice PAC ID
0345146254
Professional Enrollment ID
I20160125002187
Address ID
FL321142709DA303XXBLVD534
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience56
Completeness75
Years active:16State licenses:1Digital endpointsOther names

2,163 GENERAL SURGERY in FL

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Provider Addresses for LARS SPENCER NELSON (MD)

  • Whole Foods Market, 10601, San Jose Boulevard, Plummers, Jacksonville, Duval County, Florida, 32257, United States

    SUITE 300

    JACKSONVILLE, FL 322231613

    Phone: (904) 396-1725

    Fax: (904) 399-1717

    Type: Mailing

  • Twin Lakes Medical Center, 1890, LPGA Boulevard, The Preserve at Daytona, Daytona Beach, Volusia County, Florida, 32117, United States

    SUITE 250

    DAYTONA BEACH, FL 321177130

    Phone: (386) 274-0250

    Fax: (386) 274-0268

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 81 Open Payments records for all available years, with a total value of $2,852.

Total Amount is formed as General ($2,852) + Research ($0) + Ownership ($0) = $2,852.

Last reported payment date: 2024-12-19 • Largest payer in this snapshot: Ethicon US, LLC ($297).

Total Amount

$2,852

General + Research + Ownership

Payments

81

Total payment records

General Amount

$2,852

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-12-19

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

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: 2016-01-25

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
I20160125002187IGeneral SurgeryFLTBD

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.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99232Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes5935$0
99222Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes5454$0
99231Subsequent hospital care with straightforward or low level of medical decision making, per day, if using time, at least 25 minutes5322$0
99213Established patient office or other outpatient visit, 20-29 minutes4835$0
99214Established patient office or other outpatient visit, 30-39 minutes3127$0
View full utilization report →

Insurance plans in this area (ZIP 32223)

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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: 0345146254View full group profile

Reviews

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Frequently asked questions

Can I use this page to confirm LARS SPENCER NELSON (MD)'s NPI?
Yes. LARS SPENCER NELSON (MD) is listed with NPI 1780813592 in the public NPI dataset.
Can I rely on LARS SPENCER NELSON (MD) being an active provider?
As of the registry snapshot, LARS SPENCER NELSON (MD) is marked active.
What taxonomy line describes LARS SPENCER NELSON (MD)?
For research purposes, treat LARS SPENCER NELSON (MD) as Surgery Physician in this dataset. Clinical services aligned with this taxonomy classification.
Where is LARS SPENCER NELSON (MD) based?
LARS SPENCER NELSON (MD) is tied to Jacksonville, Florida in the data we show; additional addresses may exist on the full record.
Is specialty guaranteed by NPI alone?
Taxonomy selections describe intent; scope of practice still follows state law.

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