BRAD RODNEY LARSEN (P.A.) – Medical Physician Assistant, NPI 1063430890
Medical Physician Assistant
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Profile Insights
NPPES metrics only — not quality of care.
1,971 PHYSICIAN ASSISTANT in UT
Provider Addresses for BRAD RODNEY LARSEN (P.A.)
127, 500 East, Salt Lake City, Salt Lake County, Utah, 84102, United States
SUITE 600
SALT LAKE CITY, UT 841021971
Phone: (801) 587-6336
Fax: (801) 715-8228
Type: Mailing
2950 N Church St
Ste 200
Layton, UT 840406504
Phone: (801) 771-7700
Fax: (801) 546-2422
Type: Location
1701 E PFLUGERVILLE PKWY
PFLUGERVILLE, TX 786608990
Phone: (512) 259-6000
Fax: (512) 260-6005
Type: Location
PO BOX 844658
DALLAS, TX 752844658
Phone: (254) 724-2111
Fax: (801) 715-8228
Type: Mailing
Church Street, Layton, Davis County, Utah, 84041, United States
STE 200
LAYTON, UT 840406504
Phone: (801) 771-7700
Fax: (801) 546-2422
Type: Location
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 $46.
Total Amount is formed as General ($46) + Research ($0) + Ownership ($0) = $46.
Last reported payment date: 2023-11-15 • Largest payer in this snapshot: Stryker Corporation ($24).
Total Amount
$46
General + Research + Ownership
Payments
2
Total payment records
General Amount
$46
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2023-11-15
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Stryker Corporation | $24 |
| Boston Scientific Corporation | $22 |
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: 2008-09-23
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 2 Medicare enrollment records; no due dates published yet.
Enrollment records
2
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 |
|---|---|---|---|---|
| I20061031000440 | I | Physician Assistant | TX | TBD |
| I20080923000584 | I | Physician Assistant | UT | 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.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 93 | 92 | $0 |
| 99203 | New patient office or other outpatient visit, 30-44 minutes | 24 | 24 | $0 |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 20 | 20 | $0 |
Insurance plans in this area (ZIP 84102)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Radiation Oncology | TX | |
| U R O L O G Y | TX | |
| General Surgery | OK | |
| Certified Registered Nurse Anesthetist (Crna) | TX | |
| - | TX | |
| Anesthesiology Assistant | TX | |
| - | TX | |
| - | TX | |
| O B S T E T R I C S/ G Y N E C O L O G Y | TX | |
| - | TX |
Reviews
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