Brett David Larson, MD is a medicare enrolled "Obstetrics & Gynecology" physician in South Ogden, Utah. He graduated from medical school in 2010 and has 14 years of diverse experience with area of expertise as Obstetrics/gynecology. He is a member of the group practice Circle Of Life Inc and his current practice location is
1525 E 6000 S Ste A, South Ogden, Utah. You can reach out to his office (for appointments etc.) via phone at
(801) 337-5800.
Brett David Larson is licensed to practice in Utah (license number 12706124-1205) and he also participates in the medicare program. He
accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1104142678.
Physician's Profile
Full Name | Brett David Larson |
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Gender | Male |
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Speciality | Obstetrics/gynecology |
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Experience | 14 Years |
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Location | 1525 E 6000 S Ste A, South Ogden, Utah |
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Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
Medical Education and Training:
- Brett David Larson graduated from medical school in 2010
NPI Data:
- NPI Number: 1104142678
- Provider Enumeration Date: 04/08/2010
- Last Update Date: 08/25/2022
Medicare PECOS Information:
- PECOS PAC ID: 1052637303
- Enrollment ID: I20220607002154
Medical Identifiers
Medical identifiers for Brett David Larson such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1104142678 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
207V00000X | Obstetrics & Gynecology | 60490 (Minnesota) | Secondary |
207V00000X | Obstetrics & Gynecology | 35125228 (Ohio) | Secondary |
207V00000X | Obstetrics & Gynecology | 12706124-1205 (Utah) | Primary |
Group Practice Association
Group Practice Name | Group PECOS PAC ID | No. of Members |
Circle Of Life Inc | 5193703544 | 11 |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Brett David Larson allows following entities to bill medicare on his behalf.
Entity Name | Circle Of Life Inc |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1548284078 PECOS PAC ID: 5193703544 Enrollment ID: O20040712000677 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Brett David Larson is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Brett David Larson, MD 712 S Cascade St, Suite 102, Fergus Falls, MN 56537-2913 Ph: (218) 736-8000 | Brett David Larson, MD 1525 E 6000 S Ste A, South Ogden, UT 84405-7149 Ph: (801) 337-5800 |
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