BRETT DAVID LARSON (M.D.) – Obstetrics & Gynecology Physician, NPI 1104142678
Obstetrics & Gynecology Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
357 OBSTETRICS/GYNECOLOGY in UT
Provider Addresses for BRETT DAVID LARSON (M.D.)
1525 E 6000 S STE A
SOUTH OGDEN, UT 844057149
Phone: (801) 337-5800
Fax: (801) 337-5858
Type: Location
Lake Region Healthcare, 712, South Cascade Street, Downtown, Fergus Falls, Otter Tail County, Minnesota, 56537, United States
SUITE 102
FERGUS FALLS, MN 565372913
Phone: (218) 736-8000
Fax: (218) 739-6718
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 15 Open Payments records for all available years, with a total value of $321.
Total Amount is formed as General ($321) + Research ($0) + Ownership ($0) = $321.
Last reported payment date: 2024-11-06 • Largest payer in this snapshot: Astellas Pharma US Inc ($158).
Total Amount
$321
General + Research + Ownership
Payments
15
Total payment records
General Amount
$321
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-11-06
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Astellas Pharma US Inc | $158 |
| Biogen, Inc. | $46 |
| Baxter Healthcare | $32 |
| Organon LLC | $24 |
| Evofem Biosciences, 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: 2022-06-07
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 |
|---|---|---|---|---|
| I20220607002154 | I | Obstetrics/Gynecology | 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.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 84405)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| - | UT | |
| Nurse Practitioner | UT | |
| O B S T E T R I C S/ G Y N E C O L O G Y | UT | |
| - | UT | |
| O B S T E T R I C S/ G Y N E C O L O G Y | UT | |
| O B S T E T R I C S/ G Y N E C O L O G Y | UT | |
| Certified Nurse Midwife (Cnm) | UT | |
| O B S T E T R I C S/ G Y N E C O L O G Y | UT | |
| Nurse Practitioner | UT | |
| - | UT |
Reviews
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