NPIMap

Individual provider Active NPI

David P Larson, MD

  • Internal Medicine Physician
  • Beaverton, OR
National Provider Identifier
1992798599
Registry record updated Aug 5, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD29034 Issued in OR
Practice address
16043 SW Waxwing Way
Beaverton, OR 97007-8362
Phone
(503) 715-3414
Fax
(503) 352-4775
NPI assigned
Aug 30, 2005
Last updated
Aug 5, 2021By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 5, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 34056 AZ
Internal Medicine Physician 207R00000X MD29034 OR Primary

Addresses

Primary practice location

16043 SW Waxwing Way
Beaverton, OR 97007-8362

Mailing address

6650 SW Redwood LN Ste 380
Portland, OR 97224-7169
Phone (503) 715-3414

Other identifiers 1

IdentifierTypeStateIssuer
500605904MedicaidOR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090515000113 OR Practitioner - Internal Medicine 4688608565 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Jefferson Medical College of Thomas Jefferson University, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
David P Larson MD LLCGroup PAC ID 5092149260, 7 clinicians

Practice addresses (Care Compare)

16043 SW Waxwing Way
Beaverton, OR 97007-8362
Phone (503) 620-5141

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
93.65 of 100Reported as group
Quality
86.8
Promoting interoperability
100
Improvement activities
40
Cost
86.36

Merit-based Incentive Payment System (MIPS)

Final score
0 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
0

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
34056AZMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
David P Larson MD LLC Internal Medicine CurrentSince Oct 17, 2019 Accepting new patients
Affiliated Hospitalists, PLC Internal Medicine PastSince Jan 1, 2013 Accepting new patients
Sapphire at Tigard Rehab LLC Past Accepting new patients
Crestview Operations, LLC PastSince May 1, 2020 Accepting new patients

Locations

3900 Pacific Ave
Forest Grove, OR 97116
Phone (503) 359-0449

835 SW 11th St
Newport, OR 97365
Phone (541) 265-5356

6530 SW 30th Ave
Portland, OR 97239
Phone (503) 244-7533

745 NE 122nd Ave
Portland, OR 97230
Phone (503) 252-0241

5601 SE 122nd Ave
Portland, OR 97236
Phone (503) 760-6556

16485 SW Pacific Hwy
Tigard, OR 97224
Phone (503) 620-5141

Ownership & related parties

All facility ownership & control disclosures 10

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Avamere Crestview of PortlandPortland, OR, CCN 385031 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Apr 1, 2020
Apr 1, 2020
Avamere Rehabilitation of NewportNewport, OR, CCN 385162 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Apr 1, 2020
Apr 1, 2020
Avamere Rehabilitation of BeavertonBeaverton, OR, CCN 385195 Skilled nursing facility Contracted Managing Employee Apr 1, 2021
Avamere Rehabilitation of King CityTigard, OR, CCN 385132 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Apr 1, 2020
Apr 1, 2020
Tigard Rehabilitation and CareTigard, OR, CCN 385272 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Sep 1, 2023
Aug 1, 2023
Hillsboro Health & Rehabilitation CenterHillsboro, OR, CCN 385217 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Aug 31, 2023
Aug 31, 2023
Evergreen Post AcutePortland, OR, CCN 385258 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Sep 1, 2024
May 30, 2025
Menlo Park Post AcutePortland, OR, CCN 385044 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Sep 1, 2024
May 1, 2025
Cascade Terrace Post AcutePortland, OR, CCN 385187 Skilled nursing facility Operational/Managerial Control Sep 1, 2024
Forest Grove Post AcuteForest Grove, OR, CCN 385155 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Sep 1, 2024
Jul 11, 2025

Owned or controlled facilities with NPI records 10

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 4

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.

Hospital & facility affiliations 22

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

View all 22

NPI Registry JSON

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

{
    "created_epoch": "1125360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628121600000",
    "number": "1992798599",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6650 SW REDWOOD LN STE 380",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972247169",
            "telephone_number": "503-715-3414",
            "fax_number": "503-352-4775"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16043 SW WAXWING WAY",
            "city": "BEAVERTON",
            "state": "OR",
            "postal_code": "970078362",
            "telephone_number": "503-715-3414",
            "fax_number": "503-352-4775"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LARSON",
        "first_name": "DAVID",
        "middle_name": "P",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-08-30",
        "last_updated": "2021-08-05",
        "certification_date": "2021-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AZ",
            "license": "34056",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OR",
            "license": "MD29034",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500605904",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Beaverton, OR

Sources for this page

Verify at the official NPI Registry.