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EMILY JACKSON LARSEN
NPI 1164267191
Nurse Practitioner - Family in Glendale, AZ

Active since July 01, 2024PECOS EnrolledAccepts Medicare Assignment
18301 N 79TH AVE STE F168, GLENDALE, AZ 85308(623) 544-9090 Get Directions Write a Review

NPPES record last updated: May 26, 2025. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: May 26, 2025, Jul 1, 2024 (2 updates tracked since 2024).

About Emily Jackson Larsen NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

EMILY JACKSON LARSEN (NPI 1164267191) is an individual family provider in Glendale, Arizona, licensed in Arizona (313215) and active in the NPI registry since July 2024. She is enrolled in Medicare PECOS, maintains a secondary practice location in Peoria, and is a graduate of Other (2024).

NPPES Registry Identity

NPI1164267191
Entity TypeIndividualFemale
Primary Taxonomy363LF0000X
Provider Legal NameEMILY JACKSON LARSEN
Location Address18301 N 79TH AVE STE F168Glendale, AZ 85308-6045
Mailing Address10946 N 153rd LnSurprise, AZ 85379-5325 · (801) 808-3256
Phone(623) 544-9090
Sole ProprietorYes
Medical School CMSOtherGraduated 2024
Enumeration DateJuly 1, 2024
Last NPPES UpdateMay 26, 20252 updates tracked since enumeration
NPPES CertifiedMay 26, 2025
✔ NPI 1164267191 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
License✔ Licensed in AZ · 313215
18301 N 79TH AVE STE F168, Glendale, AZ 85308
Open in Google Maps ↗

Secondary Practice Location 1

Location 17727 W Deer Valley Rd Ste 215Peoria, AZ 85382-2121 · Phone (623) 404-2244

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arizona Complete Health, UnitedHealthcare.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Emily Jackson Larsen 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.

PECOS PAC ID7911421359
PECOS Enrollment IDI20250408000849
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Emily Larsen reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Foot & Ankle Specialists Of Arizona PLLC
Same address
Foot & Ankle Surgery
18301 N 79TH AVE STE F168
Glendale, AZ 85308
  • Reassigned Medicare billing, Arizona enrollment
  • 15 clinicians in this Medicare group
NPI 1316504574 (623) 544-9090

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 85308 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$85.89 typical visit price
range $55.44 – $168.60
Typical copayment $21.47 (range $13.86 – $42.15)
Most-billed visit code 99203
Established Patient
$98.00 typical visit price
range $17.72 – $137.41
Typical copayment $24.50 (range $4.43 – $34.35)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 14

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

NORTH GLENDALE REGENERATIVE MEDICINE PLLC
Clinic/Center (Pain)
18301 N 79TH AVE STE F168
GLENDALE, AZ 85308
Maricopa County (623) 544-9090
SOUTHWEST FOOT INSTITUTE INC
Podiatrist
18301 N 79TH AVE STE F168
GLENDALE, AZ 85308
Maricopa County (623) 544-9090
NORTH GLENDALE REGENERATIVE MEDICINE CLINIC PLLC
Clinic/Center (Ambulatory Surgical)
18301 N 79TH AVE STE F168
GLENDALE, AZ 85308
Maricopa County (623) 544-9090
MR. CHRISTOPHER ANDREW STEWART LAC
Counselor
18301 N 79TH AVE STE F168
GLENDALE, AZ 85308
Maricopa County (602) 633-2246
FOOT & ANKLE SPECIALISTS OF ARIZONA PLLC
Podiatrist (Foot & Ankle Surgery)
18301 N 79TH AVE STE F168
GLENDALE, AZ 85308
Maricopa County (623) 544-9090
UNION HILLS TREATMENT CENTER
Clinic/Center (Pain)
18301 N 79TH AVE STE F168
GLENDALE, AZ 85308
Maricopa County (801) 448-4841
UNION HILLS DME
Durable Medical Equipment & Medical Supplies
18301 N 79TH AVE STE F168
GLENDALE, AZ 85308
Maricopa County (623) 544-9090
GLENDALE REGENERATIVE MEDICINE
Clinic/Center (Pain)
18301 N 79TH AVE STE F168
GLENDALE, AZ 85308
Maricopa County (623) 544-9090

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 Emily Larsen's NPI number?

The NPI number for Emily Larsen is 1164267191. It was assigned to this individual provider in the NPPES registry on July 1, 2024.

Where is Emily Larsen located?

Emily Larsen practices at 18301 N 79th Ave Ste F168, Glendale, AZ 85308. The listed phone number is (623) 544-9090.

What is Emily Larsen's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Is Emily Larsen enrolled in Medicare?

Yes. Emily Larsen 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.

Which organization bills Medicare for Emily Larsen's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Emily Larsen reassigns Medicare benefits to Foot & Ankle Specialists Of Arizona PLLC (Glendale, AZ). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Emily Larsen's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Emily Larsen accept?

Health plans from Ambetter from Arizona Complete Health and UnitedHealthcare list Emily Larsen as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Emily Larsen was last updated on May 26, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 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.