Jason Mark Larsen, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

OPT12133TPA Issued in CA

Practice address

508 Upland St
Kenai, AK 99611-8026

Phone

(907) 335-7500

NPI assigned

Jun 6, 2006

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 4

Medicare fee-for-service enrollment

Enrolled in WA, AK2 enrollments

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 2

Specialty

Optometry

Education

University of Houston - College of Optometry, 1998

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Kenaitze Indian TribeGroup PAC ID 4082506225, 29 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Kenaitze Indian Tribe

  dba Dena'ina Wellness Center

  • Federally Qualified Health Center (FQHC)
  • Kenai, AK
  • NPI 1932114600
  Medicare reassignment Care Compare group NPD
• Apple Valley Optometry PC

  dba Apple Valley Eye Center

  • Optometrist
  • Yakima, WA
  • NPI 1689175036
  Medicare reassignment NPD Authorized official
• Kenaitze Indian Tribe

  dba Denaina Dental Clinic

  • Federally Qualified Health Center (FQHC)
  • Kenai, AK
  • NPI 1295972677
  NPD

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

{
    "created_epoch": "1149552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776038400000",
    "number": "1407895964",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 84101",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981245401",
            "telephone_number": "907-335-7500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "508 UPLAND ST",
            "city": "KENAI",
            "state": "AK",
            "postal_code": "996118026",
            "telephone_number": "907-335-7500"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2524 Westside Rd",
            "address_purpose": "LOCATION",
            "city": "Yreka",
            "state": "CA",
            "postal_code": "960979129",
            "country_code": "US",
            "telephone_number": "530-842-2760",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "206 W Rockwell Ave",
            "address_purpose": "LOCATION",
            "city": "Soldotna",
            "state": "AK",
            "postal_code": "996697439",
            "country_code": "US",
            "telephone_number": "907-335-7500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LARSEN",
        "first_name": "JASON",
        "middle_name": "MARK",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-06",
        "last_updated": "2026-04-13",
        "certification_date": "2026-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "OPT12133TPA",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP NUMBER",
            "identifier": "ZZZ13445Z",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "SDO121330",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "410039591",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1757666",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Matthew James Lafrentz
• Cassandra Delacy Landreth-Lloyd
• Kelli S Landrum, FNP-C
• Tanya Lange
• Spring E Larrow, CT
• Elizabeth Susan Latz
• Jessica Lazar, MD
• Kaylee Brianna Lazaro, RN
• Phuong Anh P Le, DMD
• Noah Leaf, PT, DPT

• Optometrist in Kenai, AK
• Providers in Kenai, AK by specialty
• Optometrist in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 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.