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Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

MRS. LISA CAROL LARSON PAC
NPI 1417945940
Physician Assistant in Chaska, MN

Active since October 10, 2005PECOS Enrolled
822 YELLOW BRICK RD, CHASKA, MN 55318(952) 448-3303(952) 448-4409 Get Directions Write a Review

NPPES record last updated: July 13, 2026. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Mrs. Lisa Carol Larson Pac NPPES

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

MRS. LISA CAROL LARSON PAC (NPI 1417945940) is an individual physician assistant in Chaska, Minnesota, licensed in Minnesota (9622) and active in the NPI registry since October 2005. She is enrolled in Medicare PECOS, is affiliated with Glencoe Regional Health, and is a graduate of Other (2000).

NPPES Registry Identity

NPI1417945940
Entity TypeIndividualFemale
Primary Taxonomy363A00000X
Provider Legal NameMRS. LISA CAROL LARSONCredential: PAC
Location Address822 YELLOW BRICK RDChaska, MN 55318-2152
Mailing Address822 Yellow Brick RdChaska, MN 55318-2152 · (952) 448-3303 · Fax (952) 448-4409
Phone(952) 448-3303
Fax(952) 448-4409
Sole ProprietorNo
Medical School CMSOtherGraduated 2000
Enumeration DateOctober 10, 2005
Last NPPES UpdateJuly 13, 2026
✔ NPI 1417945940 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
License✔ Licensed in MN · 9622
Definition
A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.
822 YELLOW BRICK RD, Chaska, MN 55318
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Other Names 1

Former Name (1)Lisa Carol Granstrom Pac

Other Identifiers 1

Medicaid414338800MN

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Medica, Sanford Health Plan.Insurance ›

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

Mrs. Lisa Carol Larson Pac 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 ID8022275544
PECOS Enrollment IDI20120210000097
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.

Areas of Expertise CMS Part B claims 2

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
18 services18 patients
Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
13 services13 patients

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Glencoe Regional Health

Critical Access Hospitals · Glencoe, MN
OwnershipVoluntary non-profit - Other
CMS Certification Number241355
Location1805 Hennepin Avenue NorthGlencoe, MN 55336 · Mc Leod County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 55318 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
$85.82 typical visit price
range $56.00 – $168.28
Typical copayment $21.45 (range $14.00 – $42.07)
Most-billed visit code 99203
Established Patient
$69.74 typical visit price
range $18.32 – $138.04
Typical copayment $17.43 (range $4.58 – $34.51)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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 Lisa Larson's NPI number?

The NPI number for Lisa Larson is 1417945940. It was assigned to this individual provider in the NPPES registry on October 10, 2005. The provider is also known as Lisa Carol Granstrom Pac.

Where is Lisa Larson located?

Lisa Larson practices at 822 Yellow Brick Rd, Chaska, MN 55318. The listed phone number is (952) 448-3303.

What is Lisa Larson's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Is Lisa Larson enrolled in Medicare?

Yes. Lisa 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.

What insurance does Lisa Larson accept?

Health plans from Medica and Sanford Health Plan list Lisa Larson 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.

Is Lisa Larson affiliated with any hospitals?

According to CMS data, Lisa Larson is affiliated with Glencoe Regional Health.

When was this NPI record last updated?

The NPPES record for Lisa Larson was last updated on July 13, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 24 days 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.