PIERCE LARKE (PA) – Physician Assistant, NPI 1407567647

PIERCE LARKE (PA) is a healthcare provider. based in Fort wayne, Indiana. specializing in PHYSICIAN ASSISTANT. They hold the professional credentials PA. They hold a License No. 10003928A (IN). The NPI Number for PIERCE LARKE (PA) is 1407567647

Main info

Male
4 Years Of Experience
Accepts Medicare Assignment
Name
PIERCE LARKE (PA)
NPI
1407567647
Phone
(260) 458-2641
Address
1717 S Calhoun St
Enumeration Date
8 December 2022
Last Update Date
23 February 2026

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2604582641
Graduation Year
2022 (4 years ago)
PAC ID
6709250814
Group Practice PAC ID
8022926294
Professional Enrollment ID
I20230313000681
Address ID
IN468025257FO1721XSTXX401
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience30
Completeness85
Years active:3State licenses:1Digital endpointsOther names

2,499 PHYSICIAN ASSISTANT in IN

Provider Addresses for PIERCE LARKE (PA)

  • 1717 S Calhoun St

    Fort Wayne, IN 468025257

    Phone: (260) 458-2641

    Type: Location

  • 2932 W LUDWIG RD

    FORT WAYNE, IN 468181328

    Phone: (260) 755-1304

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 3 Open Payments records for all available years, with a total value of $241.

Total Amount is formed as General ($241) + Research ($0) + Ownership ($0) = $241.

Last reported payment date: 2024-10-01 • Largest payer in this snapshot: ABBVIE INC. ($125).

Total Amount

$241

General + Research + Ownership

Payments

3

Total payment records

General Amount

$241

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-10-01

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: 2023-03-13

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
I20230313000681IPhysician AssistantINTBD

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 46802)

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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: 8022926294View full group profile
NameSpecialtyState
C H I R O P R A C T I CIN
C H I R O P R A C T I CIN
Family PracticeIN
-IN
-IN
O P T O M E T R YIN
Family PracticeIN
Physician AssistantIN
Physician AssistantIN
-IN

Reviews

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Frequently asked questions

How do I look up PIERCE LARKE (PA) by NPI?
Use NPI 1407567647 when you need to reference PIERCE LARKE (PA) in forms, claims, or directories.
Is PIERCE LARKE (PA)'s enrollment marked active?
An active flag here means the NPI record is not in a deactivated state.
Can you summarize PIERCE LARKE (PA)'s specialty in plain language?
Clinically, the directory lists PIERCE LARKE (PA) with Physician Assistant. Clinical services aligned with this taxonomy classification.
Where is PIERCE LARKE (PA)'s primary listing?
We display Fort Wayne, Indiana because that is what the record indicates for PIERCE LARKE (PA).
How can I contact PIERCE LARKE (PA)?
Phone or fax may appear on the official NPI record when supplied — verify before relying on them.

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