ALYSSA SUE LARSON – Occupational Therapist, NPI 1144170150

ALYSSA SUE LARSON is a healthcare provider. based in Hayden, Idaho. specializing in OCCUPATIONAL THERAPIST IN PRIVATE PRACTICE. They hold a License No. OT70086610 (WA). The NPI Number for ALYSSA SUE LARSON is 1144170150

Main info

Female
1 Year Of Experience
Accepts Medicare Assignment
Name
ALYSSA SUE LARSON
NPI
1144170150
Phone
(208) 966-4176
Address
PO BOX 1180
Enumeration Date
29 January 2026
Last Update Date
29 January 2026

Doctor Profile

Medical School Name
OTHER
Secondary Phone
5098227834
Graduation Year
2025 (1 year ago)
PAC ID
4880176064
Group Practice PAC ID
3678465234
Professional Enrollment ID
I20260305004058
Address ID
WA990197710LI21651DRXX501
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience24
Completeness85
Years active:0State licenses:1Digital endpointsOther names

460 OCCUPATIONAL THERAPIST IN PRIVATE PRACTICE in WA

Provider Addresses for ALYSSA SUE LARSON

  • PO BOX 1180

    HAYDEN, ID 838351180

    Phone: (208) 966-4176

    Type: Mailing

  • 21651 E COUNTRY VISTA DR

    LIBERTY LAKE, WA 990197708

    Phone: (208) 966-4176

    Type: Location

  • 3009 S Grand Blvd

    Spokane, WA 992032559

    Phone: (208) 966-4176

    Type: Location

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: 2026-03-05

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
I20260305004058IOccupational Therapist In Private PracticeWATBD

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 83835)

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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: 3678465234View full group profile
NameSpecialtyState
Physical Therapist In Private PracticeCO
Physical Therapist In Private PracticeID
-OR
Physical Medicine And RehabilitationWA
-ID
Physical Therapist In Private PracticeID
Physical Therapist In Private PracticeWA
Occupational Therapist In Private PracticeWA
Physical Therapist In Private PracticeID
Physical Therapist In Private PracticeID

Reviews

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Frequently asked questions

How is ALYSSA SUE LARSON identified in CMS data?
CMS-hosted NPPES data lists ALYSSA SUE LARSON with NPI 1144170150.
Does CMS list ALYSSA SUE LARSON as active?
Yes — ALYSSA SUE LARSON is active in the NPI listing used on this page.
What is ALYSSA SUE LARSON's specialty?
The listing groups ALYSSA SUE LARSON with Occupational Therapist. Clinical services aligned with this taxonomy classification.
Where is ALYSSA SUE LARSON based?
ALYSSA SUE LARSON is tied to Hayden, Idaho in the data we show; additional addresses may exist on the full record.
How many locations tie to this NPI?
3 practice locations appear in the available data.

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