TYLER ROTH LARSON PA-C
NPI 1003211103
Physician Assistant in Sweet Home, OR
About Tyler Roth Larson Pa-c NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
TYLER ROTH LARSON PA-C (NPI 1003211103) is an individual physician assistant in Sweet Home, Oregon, licensed in Oregon (PA201515) and active in the NPI registry since October 2014. He is enrolled in Medicare PECOS, is affiliated with Mckenzie-willamette Medical Center, and maintains a secondary practice location in Springfield.
NPPES Registry Identity
Specialties & Licenses
Secondary Practice Location 1
Other Identifiers 1
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Tyler Roth Larson Pa-c is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.
Hospital Affiliations CMS Care Compare
Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.
Mckenzie-Willamette Medical Center
Acute Care Hospitals · Springfield, ORPhysician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 97386 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Other Providers at the Same Location NPPES 7
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Tyler Larson's NPI number?
The NPI number for Tyler Larson is 1003211103. It was assigned to this individual provider in the NPPES registry on October 31, 2014.
Where is Tyler Larson located?
Tyler Larson practices at 1289 49th Ave, Sweet Home, OR 97386. The listed phone number is (541) 451-6250.
What is Tyler Larson's specialty?
The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.
Is Tyler Larson enrolled in Medicare?
Yes. Tyler Larson is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.
Is Tyler Larson affiliated with any hospitals?
According to CMS data, Tyler Larson is affiliated with Mckenzie-Willamette Medical Center.
When was this NPI record last updated?
The NPPES record for Tyler Larson was last updated on June 11, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Tyler Roth Larson, PA-C · NPI 1003211103
Physician Assistant physician in Sweet Home, Oregon. Individual provider, active in the CMS NPPES registry since October 31, 2014.
## Identity
- **NPI:** 1003211103 (Entity type: Individual)
- **Enumerated:** October 31, 2014
- **Primary specialty:** Physician Assistant · taxonomy 363A00000X
- **State license:** PA201515 (Oregon)
- **Sole proprietor:** No
## Practice location
- **Address:** 1289 49TH AVE, Sweet Home, OR 97386
- **Phone:** (541) 451-6250
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Medical school:** Other, class of 2014
## Record status
- **NPPES last updated:** June 11, 2026
- **Other identifiers:** Medicaid 500785150 (OR)
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Source: [NPI Profile](https://npiprofile.com/npi/1003211103) · Data from the CMS NPPES public registry.