Dr Ryan H Larsen, MD is a medicare enrolled "General Practice" physician in Logan, Utah. His current practice location is 
258 S Main St Ste 210, Logan, Utah. You can reach out to his office (for appointments etc.) via phone at 
(435) 383-6120.
Dr Ryan H Larsen is licensed to practice in Utah (license number 175141-1205) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1235224932.
			
			
			
			
			
		 
		
		 
Physician's Profile
		
			
			
			| Full Name | Dr Ryan H Larsen | 
|---|
| Gender | Male | 
|---|
| Speciality | General Practice | 
|---|
| Location | 258 S Main St Ste 210, Logan, Utah | 
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. | 
|---|
			
			 
			
						  NPI Data:
			
			- NPI Number: 1235224932
- Provider Enumeration Date: 10/04/2006
- Last Update Date: 09/27/2023
  Medicare PECOS Information:
- PECOS PAC ID: 3971525064
- Enrollment ID: I20060104000144
 
		 
		 
Medical Identifiers
		Medical identifiers for Dr Ryan H Larsen such as npi, medicare ID, medicare PIN, medicaid, etc.
		
		| Identifier | Type | State | Issuer | 
|---|
		| 1235224932 | NPI | - | NPPES | 
		
		 
Medical Taxonomies and Licenses
		
		| Taxonomy | Type | License (State) | Status | 
|---|
		| 208D00000X | General Practice | 175141-1205 (Utah) | Primary | 
		
		
			
			
			
			
		
		 
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. Dr Ryan H Larsen allows following entities to bill medicare on his behalf.
| Entity Name | Atlas Medical Utah Llc | 
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| Entity Type | Part B Supplier - Clinic/group Practice | 
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| Entity Identifiers | NPI Number: 1568928133 PECOS PAC ID: 4981937034
 Enrollment ID: O20190605001965
 | 
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| Entity Name | Sound Physicians Of Wyoming, Llc | 
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| Entity Type | Part B Supplier - Clinic/group Practice | 
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| Entity Identifiers | NPI Number: 1982982708 PECOS PAC ID: 8325214828
 Enrollment ID: O20240311002432
 | 
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| Entity Name | Atlas Medical Aco Llc | 
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| Entity Type | Part B Supplier - Clinic/group Practice | 
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| Entity Identifiers | NPI Number: 1790513109 PECOS PAC ID: 1456885227
 Enrollment ID: O20241115002118
 | 
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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. Dr Ryan H Larsen 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 | 
|---|
		| Dr Ryan H Larsen, MD 258 S Main St Ste 210,
 Logan, UT 84321-5768
 Ph: (435) 383-6120
 | Dr Ryan H Larsen, MD 258 S Main St Ste 210,
 Logan, UT 84321-5768
 Ph: (435) 383-6120
 | 
		
		 
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