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

Mr. Brandon Leon Larsen, PA-C

Individual provider Medical Physician Assistant · NPI 1215523337

Mr. Brandon Leon Larsen, PA-C is a Physician Assistant in Idaho Falls, Idaho. Qualified in 2020, 6 years ago. Practices with Adolpho Enterprise LLC, a 6-clinician group and works from 2 locations. Licensed in Idaho.

Years since qualifying
6
Licensed in
ID
In the registry since
2020
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

1301 E 17th St
Idaho Falls, ID 83404-6273
Phone: (208) 991-4296
Fax: (208) 656-2846
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 3760 Washington Pkwy, Idaho Falls, ID 83404-7593 — (208) 881-5779

Specialties & licences

Medical Physician Assistant (primary) Taxonomy 363AM0700X · Licence PA-1985 (ID)

Record details

NPI number1215523337
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorNo
NPI enumeratedDecember 13, 2020
Last updated in NPPESNovember 19, 2024
Certification dateNovember 19, 2024

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2020 (6 years in practice)
Group practice Adolpho Enterprise Llc. — 6 clinicians
Accepts Medicare assignment Not indicated
Practice locations2 on file with Medicare

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