KAMI JO LARSON HARLESS (MD) – Family Medicine Physician, NPI 1841533171
Family Medicine Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
4,141 FAMILY PRACTICE in WA
Provider Addresses for KAMI JO LARSON HARLESS (MD)
2414 4TH AVE
SEATTLE, WA 98121
Phone: (206) 477-8300
Type: Mailing
1401 MADISON ST
STE. 100
SEATTLE, WA 981041316
Phone: (206) 386-6197
Type: Location
PO BOX 19639
SPRINGFIELD, IL 627949639
Phone: (217) 545-8000
Fax: (844) 470-2488
Type: Mailing
520 N 4TH ST
SPRINGFIELD, IL 627025238
Phone: (217) 545-8000
Fax: (217) 757-8161
Type: Location
1600 E Clear Lake Ave Ste 120
Springfield, IL 627031172
Phone: (217) 545-8000
Fax: (217) 545-4735
Type: Location
1401 Madison St
Ste. 100
Seattle, WA 981041316
Phone: (206) 386-6197
Type: Location
319 E Madison St Ste 1F
Springfield, IL 627013118
Phone: (217) 545-8000
Fax: (217) 757-8161
Type: Location
2833 S Grand Ave E Ste 100
Springfield, IL 627032175
Phone: (217) 535-3100
Fax: (217) 535-3104
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
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: 2024-01-22
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 |
|---|---|---|---|---|
| I20161019000600 | I | Family Practice | WA | TBD |
| I20240122001219 | I | Family Practice | IL | 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 98121)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Clinical Social Worker | IL | |
| Physician Assistant | IL | |
| Family Practice | IL | |
| Registered Dietitian Or Nutrition Professional | IL | |
| Clinical Social Worker | IL | |
| Nurse Practitioner | IL | |
| Mental Health Counselor | IL | |
| - | IL | |
| Internal Medicine | OK | |
| Family Practice | IL |
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