SHANE R LARSON (M.D.) – Anesthesiology Physician, NPI 1528018496
Anesthesiology Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
565 ANESTHESIOLOGY in UT
Provider Addresses for SHANE R LARSON (M.D.)
274 N Main St
Logan, UT 843213915
Phone: (435) 753-1600
Fax: (435) 753-9521
Type: Location
274, Main Street, Sterling, Logan County, Colorado, 80751, United States
LOGAN, UT 843213915
Phone: (435) 753-1600
Fax: (435) 753-9521
Type: Mailing
1551 E TANGERINE RD
ORO VALLEY, AZ 857556213
Phone: (520) 901-3500
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 1 Open Payments records for all available years, with a total value of $19.
Total Amount is formed as General ($19) + Research ($0) + Ownership ($0) = $19.
Last reported payment date: 2023-01-31 • Largest payer in this snapshot: Merck Sharp & Dohme LLC ($19).
Total Amount
$19
General + Research + Ownership
Payments
1
Total payment records
General Amount
$19
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2023-01-31
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Merck Sharp & Dohme LLC | $19 |
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: 2025-12-17
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 3 Medicare enrollment records; no due dates published yet.
Enrollment records
3
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 |
|---|---|---|---|---|
| I20110124000952 | I | Anesthesiology | UT | TBD |
| I20250721000257 | I | Anesthesiology | IA | TBD |
| I20251217001982 | I | Anesthesiology | VI | 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 84321)
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Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| ANESTHESIOLOGY | UT | 00142 | Anesthesia for lens surgery | 58 | 56 |
Group practice members
| Name | Specialty | State |
|---|---|---|
| - | IA | |
| Gastroenterology, Internal Medicine | IA | |
| Nurse Practitioner | IA | |
| - | IA | |
| Nurse Practitioner | IA | |
| Physician Assistant | IA | |
| - | IN | |
| Orthopedic Surgery | IA | |
| Family Practice | IA | |
| Family Practice | IA |
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