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JENNIFER JEAN NISSLY LARSEN M.D.
NPI 1578839486
Internal Medicine in South San Francisco, CA

Active since March 25, 2012PECOS EnrolledAccepts Medicare Assignment
1200 EL CAMINO REAL DEPT 384, SOUTH SAN FRANCISCO, CA 94080(650) 742-2000 Get Directions Write a Review

NPPES record last updated: January 10, 2022. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Jan 10, 2022, Jun 1, 2020 (2 updates tracked since 2020).

About Jennifer Jean Nissly Larsen M.d. NPPES

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

JENNIFER JEAN NISSLY LARSEN M.D. (NPI 1578839486) is an individual internal medicine provider in South San Francisco, California, licensed in California (A122827) and active in the NPI registry since March 2012. She is enrolled in Medicare PECOS, maintains a secondary practice location in Santa Clara, and is a graduate of Jefferson Medical College Of Thomas Jefferson University (2011).

NPPES Registry Identity

NPI1578839486
Entity TypeIndividualFemale
Primary Taxonomy207R00000X
Provider Legal NameJENNIFER JEAN NISSLY LARSENCredential: M.D.
Location Address1200 EL CAMINO REAL DEPT 384South San Francisco, CA 94080-3208
Mailing Address1200 El Camino Real Dept 384South San Francisco, CA 94080-3208
Phone(650) 742-2000
Sole ProprietorNo
Medical School CMSJefferson Medical College Of Thomas Jefferson UniversityGraduated 2011
Enumeration DateMarch 25, 2012
Last NPPES UpdateJanuary 10, 20222 updates tracked since enumeration
NPPES CertifiedJune 1, 2020
✔ NPI 1578839486 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
License✔ Licensed in CA · A122827
Definition
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X
1200 EL CAMINO REAL DEPT 384, South San Francisco, CA 94080
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Other Names 1

Other Name (5)Jennifer Jean Nissly

Secondary Practice Location 1

Location 1710 Lawrence Expy, Department 384, GMESanta Clara, CA 95051-5173 · Phone (408) 851-5100

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

Jennifer Jean Nissly Larsen M.d. 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 ID3476781766
PECOS Enrollment IDI20141229002156
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 Jennifer Larsen reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Permanente Medical Group Inc
8.7 mi
Internal Medicine
2238 GEARY
San Francisco, CA 94116
  • Reassigned Medicare billing, California enrollment
  • 20,078 clinicians in this Medicare group
NPI 1841373800 (415) 833-2200

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

Areas of Expertise CMS Part B claims

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.

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes 99232
Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.
22 services11 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 94080 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
$153.83 typical visit price
range $69.00 – $202.35
Typical copayment $38.45 (range $17.25 – $50.58)
Most-billed visit code 99204
Established Patient
$119.48 typical visit price
range $23.44 – $166.46
Typical copayment $29.87 (range $5.86 – $41.61)
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.

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 Jennifer Larsen's NPI number?

The NPI number for Jennifer Larsen is 1578839486. It was assigned to this individual provider in the NPPES registry on March 25, 2012. The provider is also known as Jennifer Jean Nissly.

Where is Jennifer Larsen located?

Jennifer Larsen practices at 1200 El Camino Real Dept 384, South San Francisco, CA 94080. The listed phone number is (650) 742-2000.

What is Jennifer Larsen's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Is Jennifer Larsen enrolled in Medicare?

Yes. Jennifer 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 Jennifer Larsen's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Jennifer Larsen reassigns Medicare benefits to Permanente Medical Group Inc (San Francisco, CA). 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 Jennifer Larsen's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Jennifer Larsen was last updated on January 10, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years 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.