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

Jacob Larsen, PA

Individual provider Physician Assistant · NPI 1558730291

Jacob Larsen, PA is a Physician Assistant in Twin Falls, Idaho. Qualified in 2015, 11 years ago. Practices with St Lukes Clinic LLC, a 310-clinician group and accepts Medicare assignment. Licensed in Idaho.

Years since qualifying
11
Licensed in
ID
In the registry since
2015
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

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Practice location Address checks out

775 Pole Line Rd W Ste 103
Twin Falls, ID 83301-5819
Phone: (480) 620-2084
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X (ID)

Record details

NPI number1558730291
Entity typeIndividual (Type 1)
GenderMale
Credentials PA
Sole proprietorNo
NPI enumeratedSeptember 23, 2015
Last updated in NPPESSeptember 23, 2015
Mailing address680 Sunrise Blvd, Twin Falls, ID 83301-7060

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2015 (11 years in practice)
Group practice St Lukes Clinic Llc — 310 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations4 on file with Medicare

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