Tyler J. Larson, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT-4158 Issued in ID

Practice address

3155 Channing Way Ste D
Idaho Falls, ID 83404-7534

Phone

(208) 552-2700

Fax

(208) 552-1533

NPI assigned

Aug 10, 2015

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

Medicare fee-for-service enrollment

Enrolled in NM

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Three Rivers Physical Therapy IncGroup PAC ID 1153543632, 3 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

26.76 of 100Reported as individual

Quality

0

Improvement activities

0

Cost

89.22

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Three Rivers Physical Therapy Inc

  • Physical Therapy Clinic/Center
  • Farmington, NM
  • NPI 1811256860

  NM, Physical Therapist

  Medicare reassignment Care Compare group NPD
• Pick PT Ammon LLC

  • Physical Therapy Clinic/Center
  • Idaho Falls, ID
  • NPI 1831972561

  Physical Therapist

  NPD
• Jacksonville Physical Therapy Center, Inc.

  • Physical Therapy Clinic/Center
  • Jacksonville, NC
  • NPI 1558546184
  NPD (past)

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

{
    "created_epoch": "1439164800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1440979200000",
    "number": "1346626652",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1560 S CAROL ST",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836461839",
            "telephone_number": "208-288-1155",
            "fax_number": "208-288-0424"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3155 CHANNING WAY STE D",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834047534",
            "telephone_number": "208-552-2700",
            "fax_number": "208-552-1533"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LARSON",
        "first_name": "TYLER",
        "middle_name": "J.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-08-10",
        "last_updated": "2015-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "ID",
            "license": "PT-4158",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Steven J. Larsen, FAGD DDS
• Boyd Eric Larson, PA-C
• Brandy Lee Larson, FNP
• Gracie Larson
• Ryan Larson
• Kari Anne Lasco-Sanders, DPT
• Ricky Dwayne Latham, MD
• Latino Stand Up
• Latino Stand Up
• Latino Stand Up Idaho LLC

• All providers in Idaho Falls, ID
• Physical Therapist in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.