DR. NICOLE LYNN LARSON (DNP, APRN, PMHNP-BC) – Psychiatric/Mental Health Nurse Practitioner, NPI 1720048317
Psychiatric/Mental Health Nurse Practitioner
Main info
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for DR. NICOLE LYNN LARSON (DNP, APRN, PMHNP-BC)
149 THOMPSON AVE E STE 150
WEST ST PAUL, MN 551183238
Phone: (651) 450-0860
Fax: (651) 450-0759
Type: Location
4240 PARK GLEN RD
ST LOUIS PARK, MN 554165427
Phone: (612) 925-6033
Fax: (612) 925-8496
Type: Mailing
15265 CARROUSEL WAY
ROSEMOUNT, MN 550681760
Phone: (952) 443-4600
Fax: (651) 322-4603
Type: Mailing
1900, Silver Lake Road Northwest, New Brighton, Ramsey County, Minnesota, 55112, United States
SUITE 110
NEW BRIGHTON, MN 551121786
Phone: (651) 379-1718
Fax: (651) 379-1738
Type: Mailing
147th Street West, Redwood, Apple Valley, Dakota County, Minnesota, 55124, United States
SUITE 204
APPLE VALLEY, MN 551247850
Phone: (952) 997-3020
Fax: (952) 997-3026
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
Loading prescription activity...
Open Payments (CMS)
CMS reports 1 Open Payments records for all available years, with a total value of $20.
Total Amount is formed as General ($20) + Research ($0) + Ownership ($0) = $20.
Last reported payment date: 2024-04-30 • Largest payer in this snapshot: ITI, Inc. (d/b/a Intra-Cellular Therapies, Inc.) ($20).
Total Amount
$20
General + Research + Ownership
Payments
1
Total payment records
General Amount
$20
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-04-30
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| ITI, Inc. (d/b/a Intra-Cellular Therapies, Inc.) | $20 |
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: 2005-08-29
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 |
|---|---|---|---|---|
| I20050829000876 | I | Nurse Practitioner | MN | 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 55118)
Loading plans...
Reviews
All reviews are moderated before publication. Reviews reflect users' opinions; we do not verify the accuracy of individual reviews.
No reviews yet. Be the first to share your experience — your opinion helps families compare providers.