Individual provider Active NPI

Charles Steven Larsen, PA

  • Physician Assistant
  • Scottsdale, AZ
National Provider Identifier
1164496030
Registry record updated Nov 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
3179 Issued in AZ
Practice address
3501 N Scottsdale Rd Ste 130
Scottsdale, AZ 85251-5649
Phone
(480) 425-5000
Fax
(480) 425-5033
NPI assigned
Feb 15, 2006
Last updated
Nov 25, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 25, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 3179 AZ Primary
Surgical Physician Assistant 363AS0400X 3179 AZ
Diagnostic Radiology Physician 2085R0202X 3179 AZ

Addresses

Primary practice location

3501 N Scottsdale Rd Ste 130
Scottsdale, AZ 85251-5649

Mailing address

2323 W Rose Garden LN
Phoenix, AZ 85027-2530
Phone (602) 521-6200

Other identifiers 1

IdentifierTypeStateIssuer
636186MedicaidAZ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ, WI, WA, FL, IN, TX6 enrollments
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 6

Enrollment IDStateProvider typePAC IDDetails
I20050509000659 AZ Practitioner - Physician Assistant 7517907645 Reassigns benefits to 5 organizations
I20250708002849 WI Practitioner - Physician Assistant 7517907645 Reassigns benefits to 2 organizations
I20250905004115 WA Practitioner - Physician Assistant 7517907645 Reassigns benefits to 1 organization
I20251027002635 FL Practitioner - Physician Assistant 7517907645 Reassigns benefits to 1 organization
I20260422002220 IN Practitioner - Physician Assistant 7517907645 Reassigns benefits to 1 organization
I20260526000917 TX Practitioner - Physician Assistant 7517907645 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Imaging Associates of Indiana PCGroup PAC ID 1254503345, 293 clinicians
Sonoran Radiology LTDGroup PAC ID 3375964505, 466 clinicians

Practice addresses (Care Compare)

1201 S Main St
Crown Point, IN 46307-8481
Phone (219) 757-6320

1625 N Campbell Ave
Tucson, AZ 85719-4330
Phone (832) 915-2534

5555 W Thunderbird Rd
Glendale, AZ 85306-4622
Phone (832) 915-2534

6200 N la Cholla Blvd
Tucson, AZ 85741-3529
Phone (832) 915-2534

6750 E Baywood Ave
Mesa, AZ 85206-1749
Phone (832) 915-2534

9201 W Thomas Rd
Phoenix, AZ 85037-3332
Phone (832) 915-2534

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
3179AZMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Mori Bean and Brooks Inc Diagnostic Radiology CurrentSince Aug 17, 2025 Accepting new patients
Multicare Health System CurrentSince Aug 1, 2025 Accepting new patients
Medical X-Ray Consultants, LTD Diagnostic Radiology CurrentSince Jul 13, 2025 Accepting new patients
Multicare Health System CurrentSince Aug 1, 2025 Accepting new patients
Tri-City Express Care, PLLC CurrentSince Jan 18, 2015 Accepting new patients
Banner Imaging Services LLC CurrentSince Jan 13, 2026 Accepting new patients
Banner Imaging Services LLC Diagnostic Radiology CurrentSince Jan 13, 2026 Accepting new patients
Banner Imaging Services LLC Diagnostic Radiology Current Accepting new patients
Premier Radiology Wisconsin, LLC Diagnostic Radiology CurrentSince May 24, 2025 Accepting new patients
Heart and Lung Institute of Utah Inc Past Accepting new patients
Scottsdale Medical Imaging, LTD Diagnostic Radiology Past Accepting new patients
Urology Associates, LTD Past Accepting new patients

Locations (25 of 31)

1828 E Florence Blvd
Ste 118
Casa Grande, AZ 85122
Phone (520) 381-9729

1076 W Chandler Blvd
Ste 120
Chandler, AZ 85224
Phone (480) 821-9198

495 N Pinal Pkwy
Ste 106
Florence, AZ 85132
Phone (520) 568-0573

665 N Gilbert Rd
Ste 154
Gilbert, AZ 85234
Phone (480) 507-4500

890 W Elliot Rd
Ste 103
Gilbert, AZ 85233
Phone (480) 214-4466

920 E Williams Field Rd
Ste 101
Gilbert, AZ 85295
Phone (480) 499-0201

18275 N 59th Ave
Ste 168K
Glendale, AZ 85308
Phone (602) 889-1977

5310 W Thunderbird Rd
Ste 100
Glendale, AZ 85306
Phone (602) 978-0892

5601 W Eugie Ave
Ste 102
Glendale, AZ 85304
Phone (602) 588-3420

5605 W Eugie Ave
Ste 110
Glendale, AZ 85304
Phone (602) 938-2002

5757 W Thunderbird Rd
Ste W100
Glendale, AZ 85306
Phone (623) 931-7999

1450 S Dobson Rd
Ste A100
Mesa, AZ 85202
Phone (480) 545-9779

1810 S Power Rd
Ste 101
Mesa, AZ 85206
Phone (480) 214-0045

415 N Val Vista Dr
Ste 101
Mesa, AZ 85213
Phone (480) 654-5661

6424 E Broadway Rd
Ste 101
Mesa, AZ 85206
Phone (602) 830-0619

6553 E Baywood Ave
Ste 102
Mesa, AZ 85206
Phone (480) 268-7600

16641 N 40th St
Ste 1
Phoenix, AZ 85032
Phone (623) 931-7999

18444 N 25th Ave
Ste 140
Phoenix, AZ 85023
Phone (623) 465-6940

4200 E Camelback Rd
Ste 105
Phoenix, AZ 85018

9305 W Thomas Rd
Ste 100
Phoenix, AZ 85037
Phone (623) 842-5652

7730 E McDowell Rd
Ste 101
Scottsdale, AZ 85257
Phone (480) 699-3314

10474 W Thunderbird Blvd
Ste 100
Sun City, AZ 85351
Phone (623) 832-5316

13909 W Camino del Sol
Ste 101
Sun City West, AZ 85375
Phone (623) 544-7300

1840 E Warner Rd
Ste 114
Tempe, AZ 85284
Phone (480) 768-2800

7850 N Silverbell Rd
Ste 132
Tucson, AZ 85743
Phone (480) 500-2286

Organizations & group practices 18

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

View all 18

Hospital & facility affiliations 4

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

NPI Registry JSON

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

{
    "created_epoch": "1139961600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1764028800000",
    "number": "1164496030",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2323 W ROSE GARDEN LN",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850272530",
            "telephone_number": "602-521-6200",
            "fax_number": "623-842-5640"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3501 N SCOTTSDALE RD STE 130",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852515649",
            "telephone_number": "480-425-5000",
            "fax_number": "480-425-5033"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LARSEN",
        "first_name": "CHARLES",
        "middle_name": "STEVEN",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-15",
        "last_updated": "2025-11-25",
        "certification_date": "2025-11-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AZ",
            "license": "3179",
            "primary": true
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "AZ",
            "license": "3179",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "AZ",
            "license": "3179",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "636186",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Scottsdale, AZ

Sources for this page

Verify at the official NPI Registry.