LARRY D ALEXANDER (P.A.) – Surgical Physician Assistant, NPI 1629092424

LARRY D ALEXANDER (P.A.) is a healthcare provider. based in Traverse city, Michigan. specializing in PHYSICIAN ASSISTANT. They hold the professional credentials P.A.. They hold a License No. 5601004425 (MI). The NPI Number for LARRY D ALEXANDER (P.A.) is 1629092424

Main info

Male
22 Years Of Experience
Accepts Medicare Assignment
Name
LARRY D ALEXANDER (P.A.)
NPI
1629092424
Phone
(231) 935-0900
Address
4045 W Royal Dr
Enumeration Date
26 July 2006
Last Update Date
29 July 2019

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2319358000
Graduation Year
2004 (22 years ago)
PAC ID
7810952546
Group Practice PAC ID
3072426287
Professional Enrollment ID
I20041122001197
Address ID
MI496847823TR1400XDRXX400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience52
Completeness75
Years active:19State licenses:1Digital endpointsOther names

6,069 PHYSICIAN ASSISTANT in MI

Provider Addresses for LARRY D ALEXANDER (P.A.)

  • 4045 W Royal Dr

    Traverse City, MI 496848965

    Phone: (231) 935-0900

    Fax: (231) 935-0308

    Type: Location

  • 4045, West Royal Drive, Garfield Township, Grand Traverse County, Michigan, 49684, United States

    TRAVERSE CITY, MI 496848965

    Phone: (231) 935-0900

    Fax: (231) 935-0308

    Type: Mailing

  • 300, Sixth Street, Central Neighborhood, Traverse City, Grand Traverse County, Michigan, 49684, United States

    TRAVERSE CITY, MI 496842360

    Phone: (231) 935-2400

    Fax: (231) 392-2424

    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: 2004-11-22

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
I20041122001197IPhysician AssistantMITBD

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
99221Initial hospital care with straightforward or low level of medical decision making, per day, if using time, at least 40 minutes1818$0
99222Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes1515$0
View full utilization report →

Insurance plans in this area (ZIP 49684)

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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: 3072426287View full group profile

Reviews

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Frequently asked questions

Can I cross-check LARRY D ALEXANDER (P.A.) using NPI 1629092424?
NPI 1629092424 belongs to LARRY D ALEXANDER (P.A.); compare other details if you need extra assurance.
Is LARRY D ALEXANDER (P.A.) still an active registrant?
LARRY D ALEXANDER (P.A.) carries an active NPI according to the public dataset.
What area of care is associated with LARRY D ALEXANDER (P.A.)?
LARRY D ALEXANDER (P.A.)'s record emphasizes Surgical Physician Assistant. Clinical services aligned with this taxonomy classification.
Is LARRY D ALEXANDER (P.A.) associated with Traverse City?
Public fields place LARRY D ALEXANDER (P.A.) around Traverse City, Michigan. Always confirm the exact site before visiting.
When was this NPI issued?
Enumeration for LARRY D ALEXANDER (P.A.) is noted as July 26, 2006 where the registry provides it.

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