BRENNEN LARSEN (PA-C) – Physician Assistant, NPI 1740659010

BRENNEN LARSEN (PA-C) is a healthcare provider. based in Rexburg, Idaho. specializing in PHYSICIAN ASSISTANT. They hold the professional credentials PA-C. They hold a License No. 6141 (AZ). The NPI Number for BRENNEN LARSEN (PA-C) is 1740659010

Main info

Male
Sole Proprietor
11 Years Of Experience
Accepts Medicare Assignment
Name
BRENNEN LARSEN (PA-C)
NPI
1740659010
Phone
(208) 881-5222
Address
21 WINN DR
Enumeration Date
17 September 2015
Last Update Date
19 November 2019

Doctor Profile

Medical School Name
OTHER
Secondary Phone
-
Graduation Year
2015 (11 years ago)
PAC ID
6608172853
Group Practice PAC ID
4981846698
Professional Enrollment ID
I20170109001928
Address ID
ID834405277RE21XXXDRXX300
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience34
Completeness75
Years active:10State licenses:1Digital endpointsOther names

1,534 PHYSICIAN ASSISTANT in ID

Provider Addresses for BRENNEN LARSEN (PA-C)

  • 21 WINN DR

    REXBURG, ID 834405277

    Phone: (208) 881-5222

    Fax: (887) 441-4715

    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)

CMS reports 7 Open Payments records for all available years, with a total value of $156.

Total Amount is formed as General ($156) + Research ($0) + Ownership ($0) = $156.

Last reported payment date: 2024-04-24 • Largest payer in this snapshot: ABBVIE INC. ($111).

Total Amount

$156

General + Research + Ownership

Payments

7

Total payment records

General Amount

$156

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-04-24

Latest reported date

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: 2017-01-09

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
I20170109001928IPhysician AssistantIDTBD

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
99213Established patient office or other outpatient visit, 20-29 minutes12188$0
96372Injection of drug or substance under skin or into muscle5718$0
J0696Injection, ceftriaxone sodium, per 250 mg4411$0
99203New patient office or other outpatient visit, 30-44 minutes2828$0
81003Automated urinalysis test2624$0
View full utilization report →

Insurance plans in this area (ZIP 83440)

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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: 4981846698View full group profile
NameSpecialtyState
Family PracticeID
Family PracticeID
Physician AssistantWA
Family PracticeID
Physician AssistantID
Physician AssistantKS
Physician AssistantID

Reviews

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Frequently asked questions

Can I verify BRENNEN LARSEN (PA-C) with an NPI only?
You can start verification with NPI 1740659010 for BRENNEN LARSEN (PA-C), then check state licensing separately.
Can I rely on BRENNEN LARSEN (PA-C) being an active provider?
As of the registry snapshot, BRENNEN LARSEN (PA-C) is marked active.
What is BRENNEN LARSEN (PA-C) best known for clinically?
Directory data describes BRENNEN LARSEN (PA-C) with Physician Assistant. Clinical services aligned with this taxonomy classification.
What area does BRENNEN LARSEN (PA-C) serve?
BRENNEN LARSEN (PA-C)'s listing highlights Rexburg, Idaho; more addresses can appear in NPPES.
What does 'Individual Provider' mean on this profile?
Entity type tells you whether the number belongs to a person or an organization.

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