Brett David Larson, MD is a medicare enrolled "Obstetrics & Gynecology" physician in South Ogden, Utah. He graduated from medical school in 2010 and has 15 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 | 15 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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