TISHA MARIE LARSEN – Adult Psychiatric/Mental Health Registered Nurse, NPI 1578954855
Adult Psychiatric/Mental Health Registered Nurse
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
3,379 NURSE PRACTITIONER in OR
Provider Addresses for TISHA MARIE LARSEN
2371 NE STEPHENS ST
SUITE 200
ROSEBURG, OR 974701372
Phone: (541) 672-8533
Fax: (541) 672-4993
Type: Mailing
PO BOX 1121
ROSEBURG, OR 974700254
Phone: (541) 672-2691
Type: Mailing
621 W MADRONE ST
ROSEBURG, OR 974703090
Phone: (541) 440-3500
Fax: (541) 957-3003
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 9 Open Payments records for all available years, with a total value of $319.
Total Amount is formed as General ($319) + Research ($0) + Ownership ($0) = $319.
Last reported payment date: 2024-11-11 • Largest payer in this snapshot: Alkermes, Inc. ($138).
Total Amount
$319
General + Research + Ownership
Payments
9
Total payment records
General Amount
$319
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-11-11
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Alkermes, Inc. | $138 |
| Otsuka America Pharmaceutical, Inc. | $121 |
| Teva Pharmaceuticals USA, Inc. | $22 |
| ABBVIE INC. | $20 |
| Indivior Inc. | $17 |
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: 2018-11-05
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
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20181105000870 | I | Nurse Practitioner | OR | TBD |
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.
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 97470)
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Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| NURSE PRACTITIONER | OR | 83036 | Hemoglobin A1C level | 23 | 15 |
Group practice members
| Name | Specialty | State |
|---|---|---|
| Clinical Social Worker | OR | |
| Mental Health Counselor | OR | |
| Physician Assistant | OR | |
| Nurse Practitioner | OR | |
| Nurse Practitioner | NE | |
| P S Y C H I A T R Y | ID | |
| - | WA | |
| Nurse Practitioner | CA | |
| - | OR | |
| Nurse Practitioner | OR |
Reviews
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