KRISTIN MICHELLE LARSON (PAC) – Physician Assistant, NPI 1730142142

KRISTIN MICHELLE LARSON (PAC) is a healthcare provider. based in Maplewood, Minnesota. specializing in PHYSICIAN ASSISTANT. They hold the professional credentials PAC. They hold a License No. 9474 (MN). The NPI Number for KRISTIN MICHELLE LARSON (PAC) is 1730142142

Main info

Female
27 Years Of Experience
Accepts Medicare Assignment
Name
KRISTIN MICHELLE LARSON (PAC)
NPI
1730142142
Phone
(612) 444-3247
Address
2480 WHITE BEAR AVE N STE 104
Enumeration Date
7 April 2006
Last Update Date
5 August 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
6124443247
Graduation Year
1999 (27 years ago)
PAC ID
8729173562
Group Practice PAC ID
1456575695
Professional Enrollment ID
I20071009000208
Address ID
MN551094568MA2480XNXXX501
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience64
Completeness85
Years active:20State licenses:1Digital endpointsOther names

4,031 PHYSICIAN ASSISTANT in MN

Provider Addresses for KRISTIN MICHELLE LARSON (PAC)

  • 2480 WHITE BEAR AVE N STE 104

    MAPLEWOOD, MN 551094568

    Phone: (612) 444-3247

    Fax: (612) 888-9247

    Type: Mailing

  • Parklawn Avenue, Centennial Lakes, Edina, Hennepin County, Minnesota, 55435, United States

    SUITE 120

    EDINA, MN 554355655

    Phone: (952) 831-4454

    Fax: (952) 278-6947

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 2 Open Payments records for all available years, with a total value of $30.

Total Amount is formed as General ($30) + Research ($0) + Ownership ($0) = $30.

Last reported payment date: 2024-10-02 • Largest payer in this snapshot: ABBVIE INC. ($30).

Total Amount

$30

General + Research + Ownership

Payments

2

Total payment records

General Amount

$30

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-10-02

Latest reported date

Top Companies

Largest payers in this snapshot

CompanyAmount
ABBVIE INC.$30
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: 2007-10-09

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
I20071009000208IPhysician AssistantMNTBD

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
94375Test to measure rate of airflow1714$0
95012Test to measure the level of nitric oxide gas1412$0
99214Established patient office or other outpatient visit, 30-39 minutes1412$0
View full utilization report →

Insurance plans in this area (ZIP 55109)

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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: 1456575695View full group profile
NameSpecialtyState
Physician AssistantMN
Physician AssistantMN
Physician AssistantMN
-MN
Physician AssistantMN

Reviews

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Frequently asked questions

What federal number belongs to KRISTIN MICHELLE LARSON (PAC)?
The federal identifier for KRISTIN MICHELLE LARSON (PAC) is NPI 1730142142.
Is KRISTIN MICHELLE LARSON (PAC)'s NPI currently valid?
The extract we use shows KRISTIN MICHELLE LARSON (PAC) as active.
What does KRISTIN MICHELLE LARSON (PAC) treat or focus on?
Patients typically see KRISTIN MICHELLE LARSON (PAC) under the specialty Physician Assistant. Clinical services aligned with this taxonomy classification.
What location metadata exists for KRISTIN MICHELLE LARSON (PAC)?
The page summarizes Maplewood, Minnesota for KRISTIN MICHELLE LARSON (PAC); expand the address list for detail.
Is KRISTIN MICHELLE LARSON (PAC) a real provider?
This page reflects official NPPES data for NPI 1730142142. Always confirm identity and privileges with the practice and licensing boards.

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