JACOB DANIEL LARSON PA-C
NPI 1174084149
Physician Assistant in San Diego, CA
About Jacob Daniel Larson Pa-c NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
JACOB DANIEL LARSON PA-C (NPI 1174084149) is an individual physician assistant in San Diego, California, licensed in California (58776) and active in the NPI registry since March 2019. He is enrolled in Medicare PECOS and is a graduate of Other (2020).
NPPES Registry Identity
Specialties & Licenses 2
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
Jacob Daniel 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.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 92127 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 Jacob Larson's NPI number?
The NPI number for Jacob Larson is 1174084149. It was assigned to this individual provider in the NPPES registry on March 30, 2019.
Where is Jacob Larson located?
Jacob Larson practices at 18655 W Bernardo Dr, San Diego, CA 92127. The listed phone number is (858) 939-9914.
What is Jacob Larson's specialty?
The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.
Is Jacob Larson enrolled in Medicare?
Yes. Jacob 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.
When was this NPI record last updated?
The NPPES record for Jacob Larson was last updated on May 6, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 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.
# Jacob Daniel Larson, PA-C · NPI 1174084149
Physician Assistant physician in San Diego, California. Individual provider, active in the CMS NPPES registry since March 30, 2019.
## Identity
- **NPI:** 1174084149 (Entity type: Individual)
- **Enumerated:** March 30, 2019
- **Primary specialty:** Physician Assistant · taxonomy 363A00000X
- **State license:** 58776 (California)
- **Sole proprietor:** No
## Practice location
- **Address:** 18655 W BERNARDO DR, San Diego, CA 92127-3099
- **Phone:** (858) 939-9914
## 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 2020
## Record status
- **NPPES last updated:** May 6, 2025
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Source: [NPI Profile](https://npiprofile.com/npi/1174084149) · Data from the CMS NPPES public registry.