1. Home
  2. Directory
  3. California
  4. Shasta Lake
  5. Physician Assistant
  6. NPI Profile
Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

LARISSA N BOTCHARNIKOVA PA-C
NPI 1720122054
Physician Assistant in Shasta Lake, CA

Active since February 19, 2007PECOS Enrolled
4215 FRONT ST, SHASTA LAKE, CA 96019(530) 246-5710(530) 241-7838 Get Directions Write a Review

NPPES record last updated: September 15, 2026. Verified against the NPPES registry weekly; last sync: September 27, 2026.

About Larissa N Botcharnikova Pa-c NPPES

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

LARISSA N BOTCHARNIKOVA PA-C (NPI 1720122054) is an individual physician assistant in Shasta Lake, California, licensed in California (PA17636) and active in the NPI registry since February 2007. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1720122054
Entity TypeIndividualFemale
Primary Taxonomy363A00000X
Provider Legal NameLARISSA N BOTCHARNIKOVACredential: PA-C
Location Address4215 FRONT STShasta Lake, CA 96019-9430
Mailing AddressPo Box 992790Redding, CA 96099-2790 · (530) 246-5710 · Fax (530) 241-7838
Phone(530) 246-5710
Fax(530) 241-7838
Sole ProprietorNo
Enumeration DateFebruary 19, 2007
Last NPPES UpdateSeptember 15, 2026
NPPES CertifiedSeptember 15, 2026
✔ NPI 1720122054 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 CA · PA17636
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.
4215 FRONT ST, Shasta Lake, CA 96019
Open in Google Maps ↗

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Larissa N Botcharnikova Pa-c is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 96019 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
$90.32 typical visit price
range $58.87 – $176.60
Typical copayment $22.58 (range $14.71 – $44.15)
Most-billed visit code 99203
Established Patient
$73.16 typical visit price
range $19.28 – $144.60
Typical copayment $18.29 (range $4.82 – $36.15)
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.

Referred Medical Equipment & Supplies CMS DME claims 9

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253
DME-Other DME · category DE017N
6 suppliers31 claims71 services$4.51 avg. paid by Medicare
Electrical stimulator supplies, 2 lead, per month, (e.g., tens, nmes) A4595
DME-Other DME · category DE000N
1 supplier11 claims22 services$12.52 avg. paid by Medicare
Filter, disposable, used with positive airway pressure device A7038
DME-Other DME · category DE001N
4 suppliers11 claims66 services$2.43 avg. paid by Medicare
Nebulizer, with compressor E0570
DME-Other DME · category DE000N
1 supplier17 claims17 services$1.22 avg. paid by Medicare
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate E1390
DME-Oxygen and Supplies · category DC002N
4 suppliers122 claims122 services$78.55 avg. paid by Medicare
Portable oxygen concentrator, rental E1392
DME-Oxygen and Supplies · category DC002N
2 suppliers49 claims49 services$30.71 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 5

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

SHASTA COMMUNITY HEALTH CENTER
Clinic/Center (Federally Qualified Health Center (FQHC))
4215 FRONT ST
SHASTA LAKE, CA 96019
Shasta County (530) 246-5896
LIMS SHASTA LAKE PHARMACY INC
Pharmacy (Community/Retail Pharmacy)
4215 FRONT ST, STE 31
SHASTA LAKE, CA 96019
Shasta County (530) 275-2100
LYNN PAINTER RDH
Dental Hygienist
4215 FRONT ST
SHASTA LAKE, CA 96019
Shasta County (530) 276-9129
MRS. MELODIE G. GILL FNP
Nurse Practitioner (Family)
4215 FRONT ST
SHASTA LAKE, CA 96019
Shasta County (530) 276-9168
ELAINE PORTER MD
Family Medicine
4215 FRONT ST
SHASTA LAKE, CA 96019
Shasta County (530) 246-5710

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 Larissa Botcharnikova's NPI number?

The NPI number for Larissa Botcharnikova is 1720122054. It was assigned to this individual provider in the NPPES registry on February 19, 2007.

Where is Larissa Botcharnikova located?

Larissa Botcharnikova practices at 4215 Front St, Shasta Lake, CA 96019. The listed phone number is (530) 246-5710.

What is Larissa Botcharnikova's specialty?

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

Is Larissa Botcharnikova enrolled in Medicare?

Yes. Larissa Botcharnikova is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Larissa Botcharnikova was last updated on September 15, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 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.