Tyler Roth Larson, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA201515 Issued in OR

Practice address

1289 49TH Ave
Sweet Home, OR 97386

Phone

(541) 451-6250

NPI assigned

Oct 31, 2014

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in OR

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

McKenzie Physician Services LLCGroup PAC ID 1254307994, 48 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• McKenzie-Willamette Medical Center Hospital, Springfield, OR, CCN 380020

Merit-based Incentive Payment System (MIPS)

Final score

88.68 of 100Reported as group

Quality

75.94

Promoting interoperability

100

Improvement activities

40

Cost

83.56

Merit-based Incentive Payment System (MIPS)

Final score

94.37 of 100Reported as group

Quality

92.31

Promoting interoperability

100

Improvement activities

40

Cost

80.9

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Interoperability endpoints

• FHIR API: https://fhir.yourcareuniverse.net/tenant/42ccdd6b-a0e5-46c8-8a37-71ed6cb79014
• Direct secure messaging: trlarson@yourcarecommunity.org
• FHIR API: https://fhir-myrecord.cerner.com/r4/9d4860d0-61a4-4109-9b8d-cf607b282375/

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• McKenzie Physician Services LLC

  • General Practice Physician
  • Brentwood, TN
  • NPI 1316909054

  OR

  Medicare reassignment Care Compare group
• Mid-Valley Healthcare, Inc.

  • Rural Health Clinic/Center
  • Sweet Home, OR
  • NPI 1528334125
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• McKenzie-Willamette Regional Medical Center Associates LLC

  • General Acute Care Hospital
  • Springfield, OR
  • NPI 1568413573
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1414713600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1781136000000",
    "number": "1003211103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1189",
            "city": "CORVALLIS",
            "state": "OR",
            "postal_code": "973391189"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1289 49TH AVE",
            "city": "SWEET HOME",
            "state": "OR",
            "postal_code": "97386",
            "telephone_number": "541-451-6250"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1460 G St",
            "address_purpose": "LOCATION",
            "city": "Springfield",
            "state": "OR",
            "postal_code": "974774112",
            "country_code": "US",
            "telephone_number": "541-726-4000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LARSON",
        "first_name": "TYLER",
        "middle_name": "ROTH",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-10-31",
        "last_updated": "2026-06-11",
        "certification_date": "2026-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OR",
            "license": "PA201515",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500785150",
            "state": "OR"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tlarson276976@samhealth.direct-ci.com",
            "affiliation": "N",
            "address_1": "1289 49th Ave",
            "city": "Sweet Home",
            "state": "OR",
            "country_code": "US",
            "postal_code": "97386",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Dennis M Lynch, DC
• Kate McCaffrey, DO

• Physician Assistant in Sweet Home, OR
• Providers in Sweet Home, OR by specialty
• Physician Assistant in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.