DR. SPENCER LARSON (DO) – Family Medicine Physician, NPI 1790300143
Family Medicine Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
1,136 FAMILY PRACTICE in UT
Provider Addresses for DR. SPENCER LARSON (DO)
2376 N 400 E STE 102
TOOELE, UT 840743413
Phone: (435) 843-1225
Fax: (435) 843-1228
Type: Mailing
1316 S PROVIDENCE CIR
MESA, AZ 852093759
Phone:
Type: Mailing
1301 S CRISMON RD
MESA, AZ 852093767
Phone: (480) 358-6100
Type: Location
267 E VENTURA BLVD
STANSBURY PARK, UT 840749327
Phone: (801) 854-8629
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 44 Open Payments records for all available years, with a total value of $874.
Total Amount is formed as General ($874) + Research ($0) + Ownership ($0) = $874.
Last reported payment date: 2024-12-12 • Largest payer in this snapshot: Mylan Specialty L.P. ($228).
Total Amount
$874
General + Research + Ownership
Payments
44
Total payment records
General Amount
$874
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-12
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Mylan Specialty L.P. | $228 |
| Amgen Inc. | $99 |
| Lilly USA, LLC | $92 |
| Novo Nordisk Inc | $69 |
| AstraZeneca Pharmaceuticals LP | $57 |
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: 2023-03-24
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 |
|---|---|---|---|---|
| I20230324000620 | I | Family Practice | 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 |
|---|---|---|---|---|
| 99215 | Established patient office or other outpatient visit, 40-54 minutes | 153 | 80 | $0 |
| G2212 | Prolonged office or other outpatient evaluation and management service(s) beyond the maximum required time of the primary procedure which has been selected using total time on the date of the primary service; each additional 15 minutes by the physician or | 77 | 52 | $0 |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 74 | 54 | $0 |
| 99212 | Established patient office or other outpatient visit, 10-19 minutes | 24 | 19 | $0 |
| 90686 | Influenza vaccine, quadrivalent, preservative free, 0.5 ml dosage | 23 | 23 | $0 |
Insurance plans in this area (ZIP 84074)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Family Practice | UT |
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