1. Home
  2. Directory
  3. Arizona
  4. Mesa
  5. Nurse Practitioner
  6. NPI Profile

LARISA WILLDEN FNP-C
NPI 1598616401
Nurse Practitioner - Family in Mesa, AZ

Active since February 05, 2026PECOS Enrolled
10503 E SIMONE AVE, MESA, AZ 85212(623) 670-4378 Get Directions Write a Review

NPPES record last updated: February 5, 2026. Verified against the NPPES registry weekly; last sync: November 08, 2026.

About Larisa Willden Fnp-c NPPES

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

LARISA WILLDEN FNP-C (NPI 1598616401) is an individual family provider in Mesa, Arizona, licensed in Arizona (254108) and active in the NPI registry since February 2026. She is enrolled in Medicare PECOS and is a graduate of Other (2025).

NPPES Registry Identity

NPI1598616401
Entity TypeIndividualFemale
Primary Taxonomy363LF0000X
Provider Legal NameLARISA WILLDENCredential: FNP-C
Location Address10503 E SIMONE AVEMesa, AZ 85212-9424
Mailing Address10503 E Simone AveMesa, AZ 85212-9424 · (623) 670-4378
Phone(623) 670-4378
Sole ProprietorNo
Medical School CMSOtherGraduated 2025
Enumeration DateFebruary 5, 2026
NPPES CertifiedFebruary 5, 2026
✔ NPI 1598616401 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 · 254108
10503 E SIMONE AVE, Mesa, AZ 85212
Open in Google Maps ↗

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arizona Complete Health, Ambetter Health, Blue Cross Blue Shield of Arizona and more.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Larisa Willden Fnp-c is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID1052875275
PECOS Enrollment IDI20260709001062
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 Larisa Willden reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Summit Medical Group Arizona LLC
38 mi
Family Medicine
5620 W THUNDERBIRD RD STE F1
Glendale, AZ 85306
  • Reassigned Medicare billing, Arizona enrollment
  • 251 clinicians in this Medicare group
NPI 1053810622 (844) 969-0686

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 85212 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.

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 Larisa Willden's NPI number?

The NPI number for Larisa Willden is 1598616401. It was assigned to this individual provider in the NPPES registry on February 5, 2026.

Where is Larisa Willden located?

Larisa Willden practices at 10503 E Simone Ave, Mesa, AZ 85212. The listed phone number is (623) 670-4378.

What is Larisa Willden's specialty?

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

Is Larisa Willden enrolled in Medicare?

Yes. Larisa Willden is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Larisa Willden's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Larisa Willden reassigns Medicare benefits to Summit Medical Group Arizona LLC (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 Larisa Willden's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Larisa Willden accept?

Health plans from Ambetter Health, Ambetter from Arizona Complete Health, Blue Cross Blue Shield of Arizona and Oscar Health Plan, Inc. list Larisa Willden 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 Larisa Willden was last updated on February 5, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 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.