Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Alexander Ronald Larson

Individual provider Physician Assistant · NPI 1679168223

Alexander Ronald Larson is a Physician Assistant in Boise, Idaho. Qualified in 2021, 5 years ago. Practices with Alliance Medical Group LLC, a 130-clinician group and accepts Medicare assignment. Licensed in Idaho.

Years since qualifying
5
Licensed in
ID
In the registry since
2021
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Practice location Address checks out

1907 S Broadway Ave Ste 101
Boise, ID 83706-4229
Phone: (208) 345-1222
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence PA-2128 (ID)

Record details

NPI number1679168223
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedMarch 5, 2021
Last updated in NPPESOctober 11, 2021
Certification dateOctober 11, 2021

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2021 (5 years in practice)
Group practice Alliance Medical Group Llc — 130 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations8 on file with Medicare

Other providers in Boise